Suffering from childhood brain injury (PABI) is the number one cause of death and disability for children and young adults in the United States. "and affects most children ages (6-10) and adolescents (11-17) worldwide. Injuries can be traumatic or non-traumatic, and most patients never return to normal after suffering injuries.
There are many different symptoms such as amnesia, anhedonia, and apraxia. There is currently no cure for injury. PABI also affects the patient's family, because the patient's family must adapt to the new changes they will experience in their child. It is recommended that the family decide to obtain as much information about the injury and what to expect by going to various events and program meetings.
Video Pediatric acquired brain injury
Pediatric Acquired Brain Injury
The term "pediatrics" in this case includes brain injuries from birth to age 25, because the developing brain does not stop maturing until then. The acquired brain injury (ABI) can be sustained from traumatic brain injury (TBI) such as falls, motor vehicle incidents, sports concussions, wartime injuries, child abuse/violence, gunshot wounds, etc.) And non- traumatic (ie stroke, brain tumor, infection, poisoning, hypoxia, ischaemia, encephalopathy or substance abuse).
Maps Pediatric acquired brain injury
Pathophysiology of Pediatric Traumatic Brain Injury
The pediatric brain undergoes dramatic changes and significant neural tissue pruning throughout the development. Where areas for primary senses and motor skills are largely developed at age 4, other areas, such as the frontal cortex involved in higher-level reasoning, decision making, emotion, and impulsivity continue to thrive well into late teenagers until early 20- an. Therefore, the patient's age and brain development affect the neuronal system of what is most affected post-injury. The main structural feature of the pediatric brain makes brain tissue more susceptible to mechanical injury during TBI than the adult brain: greater water content in brain tissue and reduced myelination results in reduced shear resistance after injury. It has also been shown that the mature brain has an enlarged volume of extracellular space and a decrease in the expression of glial aquaporin 4 leading to an increased incidence of cerebral swelling after TBI. As the delay in cerebral brain flow is delayed, this unique feature of the developing brain can mediate further secondary damage, through hypoxia, excitotoxicity, free radical damage, and nerve inflammation after primary injury. Even the properties of these secondary events differ between the developing brain and the adult brain: (1) in the developing brain, excessive expression and activation of the N-methyl-D-aspartic receptor (NMDA-R) leads to increased calcium inclusion and improvement capacity for excitoxicity when compared with the adult brain and (2) developing brain has lower glutathione peroxidase activity and decreased ability to maintain storage of glutathione peroxidase, therefore developing brain is more susceptible to oxidative stress than adult brain. Damage to the developing brain, by either of the above mechanisms, may interfere with neuronal maturation, leading to neuronal loss, axonal destruction, and demyelination.
Neurocognitive Problems in Children After Traumatic Brain Injury
Postoperative physiological responses post-TBI can cause neurodegeneration in different parts of the brain in both chronic and severe cases in children. Areas of the brain that have been shown to be affected include: hippocampus, amygdala, globus pallidus, thalamus, periventricular white matter, cerebellum, and brainstem. As a result, this can lead to behavioral and cognitive problems in child development. Behavioral change has been characterized as an issue of "externalization" and "internalization". Externalization issues include various forms of aggression, hyperactivity, and impulsivity. The most common of these problems result from attention and focus changes, such as ADHD. Internalization problems include psychiatric problems such as short-term and long-term depression, anxiety, personality disorders, and post-traumatic stress disorder (PTSD). Some variables can determine the outcome of behavioral problems in post-TBI children. For example, children who already have behavioral problems before injury are more likely to develop long-term cognitive problems. Another important factor is the severity of the injury, which can be a predictor of how long the behavioral symptoms persist and whether the symptoms will increase over time.
Statistically about 54% to 63% of children develop new psychiatric disorders about 24 months after severe TBI, and 10% to 21% after mild or moderate TBI, the most common being personality change due to TBI. The symptoms can last for 6 to 24 months on average. Development of PTSD is common (68%) in the first few weeks post-injury with a decrease in the course of 2 years. In the case of severe TBI, about one-third of children suffer from depression. Children with severe TBI also have some effects on working memory, direct visual memory, and more prominent consequences in intellectual functioning, executive function (including processing and speed attention), and verbal direct and delayed memory. Some recovery was observed during the first 2 years post-injury. Children with moderate TBI show only some decrease in attention and problem solving, but a greater effect in direct visual memory. Superior frontal wounds correlate with the type of outcome, but more importantly, subcortical tissue damage may affect recovery due to lesions in the white matter tract. Children with severe TBI are at a higher risk of not achieving appropriate developments and are not pursuing peers at school because of an important learning stage in which their neural networks are plagued by injuries.
Their Suffering Behavior from Pediatric Brain Injury
In children and adolescents with brain injury, the cognitive and emotional difficulties arising from their injuries can negatively impact their level of participation in homes, schools and other social situations. This puts the patient at a disadvantage because they will not be nearly as social, or can participate in a school environment like an ordinary child. Involvement in social situations is essential for normal development of children as a means of gaining an understanding of how to work effectively with others. Group work is a huge factor now, and the ability of children to work in groups will not be effective. Furthermore, young people with brain injuries acquired are often reported to have inadequate problem-solving skills. It has the potential to hamper their performance in more academic and social settings. It is important for the rehabilitation program to address specific challenges for children who are not fully developed at the time of their injuries.
Symptoms
Some of the symptoms resulting from brain injury are amnesia, anhedonia, and apraxia.
Amnesia
"Childhood amnesia is the inability to remember a childhood." Researchers found that some daily activities such as talking, running, or playing the guitar, can not be described or remembered.
Anhedonia
A child diagnosed with anhedonia will lack interest in some of the usual activities, such as hobbies, playing sports, or engaging with friends. It is very important for a child to enjoy enjoyable childhood activities as they can help them build a social life, and easily interact with others. Not being able to do these things at a young age will only make it harder to adapt as the child gets older.
Apraxia
"Apraxia is the inability to perform educated movements, despite having the physical desire and ability to perform movement." In this case, the child may still have memories to perform the usual activities such as riding a bicycle, but still unable to complete the movement.
Training
There are many different ways to "train" children who are diagnosed with Pediatric Brain Injury. The training primarily tests their brains, to see what's wrong with the patient, and what areas need to focus on improvement.
AIM Program
"AIM is a 10-week computerized treatment program that combines goal setting, metacognitive strategy use, and computer-based exercises designed to improve various aspects of attention." "During initial meetings with children, computer programs lead physicians through an intake procedure that helps in identifying the nature and severity of child's attention difficulties and then facilitates the selection of attention training tasks and metacognitive strategies tailored to the child's needs." The role of the clinician is to choose the specific, present the disturbed mental area, as well as modify the tasks and strategies in response to the increased overtime of the patient. This is a useful way to find out what problems facing a child/teenager, while also helping them to gradually increase their injury.
Parent Help for Patients
"Researchers have determined that interventions for pediatric BI should target families because changes in one family member will affect the entire family system." "During rehabilitation, caregivers often receive skill training to improve their ability to care for their child after their brain injury.The family of rearranging and adjusting the child's environment are two main ways parents can make difficulty of injury easier on their child. parents can reset their household to apply consequences to minimize problem behavior, increase the number of positive communication between parents and children with injuries, and build a positive routine that will instill meaning into the daily life of the child.
Brain Injury Prevention Program Patient Children (PABICOP)
The team includes several members: a pediatric neurologist, community outreach coordinator, school liaison personnel, occupational therapists and speech-speakers. "
"The philosophy of a comprehensively obtained brain injury program for children/youth is that it is holistic, and parents and families are centralized, and that it combines and engages the wider community in sustainable care and management of children/adolescents with acquired brain injury while supporting the family.This also includes the idea of ​​continuity, accessibility, knowledge, collaboration, empowerment, and advocacy -
The program also gives families information about PABI, and what they should expect in the coming months. PABICOP provides family packages on how to cope with the various symptoms children may show, and some helpful suggestions. Unfortunately, sometimes program leaders give parents a shocking news that their child may never return to their original state in some aspects. "Pediatric Pediatric Brain Prevention Program (PABICOP) - An innovative comprehensive treatment model for children and adolescents with" acquired brain injury "
References
Source of the article : Wikipedia
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