The brain is the controlling organ of the body, responsible for everything we do. It controls all movements, sensations, thoughts, emotions and speech. Surprisingly, considering the function of such an important structure, the brain is very soft, almost the consistency of firm gelatin. The brain would easily be injured without the skull, the bony covering of the brain. A child’s brain continues to grow and develop in a process wired from conception through late adolescence. The developing brain was believed to be more resilient to injury than the adult brain. However, recently, this dogma has been increasingly challenged. It is more appropriate to state that the developing brain have some inherent advantages with regards to injury response and recovery; however, it also has clear vulnerabilities that to some extent based upon the underlying developmental processes ongoing at the time of injury. The adult brain is fully developed with critical cortical pathways already established and interconnected.
Traumatic Brain Injury (TBI), also referred to as an acquired brain injury, or head injury occurs when sudden trauma causes damage to the brain. One fundamental distinction of pediatric TBI is purely physical. The pediatric skull is thinner and more pliable than the adult. Particularly in infants, the flexibility of the sutures and the presence of an open fontanelle may result in significant alterations in the force transmitted to the brain by a traumatic injury, as well as differences in the response to increased intracranial pressure resulting from posttraumatic cerebral edema. During childhood, the size of the head relative to the body is also disproportionately large when compared with adults. The neck musculature is often less developed and the cervical ligaments and joints are more flexible. These factors are important considerations when evaluating a child with head injury, particularly by a medical professional whose primary experience is with adults....