Brain damage is often difficult to treat. Peripheral nerves (nerves the connect the brain and spinal cord to the rest of the body) can sometimes regenerate and heal. It’s much harder to regenerate brain tissue, meaning brain damage may be permanent. .
While the damage to the brain may be permanent, treatment is still crucial. Your doctor will find the source of the damage and correct it so that no further damage occurs. Your child may also need treatment for secondary effects of the damage.
Finding The Brain Injury
It’s difficult to determine if an infant has suffered a brain injury. One popular test for brain injury in infants is the “Glasgow Coma Scale,” which tests the baby’s neurological state. If the child scores under a 15, your doctor may recommend testing for brain damage.
Your doctor will use MRI and CT scans to get a detailed look at your little one’s brain to find the source of the trouble. These tests will show damage such as skull fractures, swelling, blood clots, contusions, and lesions. Your doctor may also use an electroencephalogram (EEG) to measure the electrical activity in your child’s brain.
Depending on the results of these scans, the doctor may be able to determine the cause of the damage. For example, a skull fracture is an obvious cause. If the cause is not obvious, your child may need further testing to find the root. For example, the doctor may test your child’s blood or spinal fluid for infections or blood disorders that can cause brain damage.
Some types of damage may not be visible on a scan or an EEG. In addition, doctors want to avoid exposing babies to MRI and CT scans if possible and won’t typically order them for a child who scores a 15 or higher on the Glasgow Coma Scale. Doctors may use cognitive and behavioral tests such as tracking the baby’s eye movements and grip to determine if some form of brain damage has occurred.
Brain damage is notoriously difficult to diagnose. In many cases, there are no signs or symptoms until the child reaches school age and is diagnosed with learning or behavioral disabilities.
Some types of brain damage do not require surgery. You’ll work with your child’s doctors to find the appropriate treatment plan.
Your child may benefit from physical therapy to help develop coordination, strength, and control. Occupational therapy can teach you and your child how to live with a disability – ordinary tasks like brushing your teeth can be much harder when brain damage affects your ability to control your muscles. Therapy can also help your child overcome behavioral problems such as aggression and poor impulse control. If your child suffers from a learning disability, therapy and specialized tutoring can help make school easier and less stressful.
If your child’s brain damage was caused by a blood disorder, stroke, jaundice, or infection, your doctor may prescribe medication to control or eliminate that cause.
The possible effects of brain damage are wide-ranging and many of them may also require medication. Your child may need medication for a seizure or movement disorder. In some cases, mood disorders and behavioral problems may be treated with a combination of mood-stabilizing drugs and therapy. Some children may need medication to help regulate blood pressure and hormone levels, depending on which part of the brain is damaged.
Some types of brain damage require surgical intervention. Brain damage requiring surgery is usually caused by physical trauma during delivery or by a perinatal stroke. Surgery can’t repair the damage to the brain but it can stop bleeding in the brain, remove blood clots, repair broken blood vessels, and relieve pressure on the brain.
Brain damage may involve bleeding or a buildup of fluid in the brain. A surgeon may place a small tube called a “shunt” through the skull and into the brain to drain off excess fluid and release pressure. The surgeon may also insert an “ICP monitor,” a device that measures the pressure on the brain.
A “craniotomy” may be used to repair damaged blood vessels and remove blood and blood clots from the brain. In this procedure, the surgeon will remove part of the skull to gain access to the brain. The surgeon will then perform whatever procedure is necessary to repair damage and prevent further damage. The skull will then be replaced and fixed with screws and metal plates.
In rare cases where of severe brain swelling (“edema”), a surgeon may perform a “decompressive craniectomy.” This is a dangerous procedure reserved for extreme, life-threatening cases. When the brain swells, it gets crushed against the inside of the skull. That can cause serious damage and may be fatal. In a decompressive craniectomy, the surgeon will remove a large portion of the skull to allow the baby’s brain to expand without pressing against the skull.
Surgery is always risky for a baby and brain surgery is even more delicate. If your child may need brain surgery, be sure to talk to your doctors and surgeons about the risks associated with the procedure and about any other options available.
Oxygen is crucial to the healing process. Even if your baby isn’t having trouble breathing, your doctor may recommend “intubation,” or placing your baby on a ventilator. A ventilator is a machine that breathes for your baby. This eases the strain on your baby’s heart and lungs. More importantly in the case of brain injury, a ventilator can be set to deliver high levels of oxygen to your baby’s blood. That extra boost of oxygen promotes healing and can help your baby recover.
Work With Your Doctor
Every brain injury is different and every child is different. You’ll need to work with your child’s doctor and other medical care providers to decide what’s best for your little one.