Traumatic Brain Injury and Cerebral Palsy

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Traumatic brain injury during labor and delivery or shortly after birth can cause cerebral palsy. Traumatic brain injuries are considered a severe medical issue. Treatment must be initiated quickly for the best possible outcome.

How Does Damage to the Brain Lead to Cerebral Palsy?

Cerebral palsy is a neurological disorder caused by brain damage or brain malformation. There are many ways a baby can suffer brain damage, including traumatic birth injuries to the head.

Brain damage in specific areas of the brain that control muscle tone, muscle movement, balance, and coordination is a hallmark of cerebral palsy.[1] 

What Causes Traumatic Brain Injuries and Brain Damage?

When it occurs during the birthing process, a traumatic brain injury (TBI) is often linked to medical negligence and medical mistakes. For example, a physician using birth-assisting tools such as forceps or a vacuum extraction tool may use too much force or use them improperly, causing significant damage to the infant’s head.

When these tools are used appropriately, they assist doctors in delivering babies in time before they experience oxygen deprivation. Doctors generally use these tools during difficult births.

The infant may be dropped shortly after delivery, causing brain injuries. This usually happens if the infant is pulled out too fast and the physician isn’t careful enough. This kind of mistake is unusual and very rare.

Brain damage can occur due to:

• Umbilical cord issues leading to oxygen deprivation
• Placental problems
• High maternal blood pressure
• Undiagnosed and untreated maternal infections
• Jaundice or elevated bilirubin (kernicterus, a rare form of brain damage, can occur when bilirubin levels are too high)

Consequences of Traumatic Brain Injuries

Cerebral palsy is one of the results of traumatic brain damage, but misusing birth-assisted tools can also lead to other severe medical conditions for the infant, including brachial palsy, Erb’s palsy, shoulder dystocia, and more.

Other conditions that can result from traumatic brain damage include:

• Head deformities
• Cephalohematoma
• Subdural hemorrhage
• Epidural hemorrhage
• Subarachnoid hemorrhage

As the baby grows older, other complications may be more apparent, including cognitive issues, missed milestones, executive functioning issues, problems with behavior and communication, sensory problems, and emotional outbursts.

Traumatic Brain Injury Symptoms

Keep in mind that traumatic brain injuries and brain damage can encompass a wide range of severity, from mild to severe. The baby’s symptoms will depend on the severity of the injury.

In general, common signs and symptoms that occur in infants with traumatic brain injury and brain damage include:

• Persistent, uncontrollable crying
• Visible injuries on the scalp
• Difficulties with feeding
• Non-responsive to light and other stimuli
• Neck stiffness
• Excessive fussiness
• Vomiting
• Unusual lethargy
• Increased blood pressure
• Slow breathing rate
• Spinal fluid may come out of the ear or nose
• Dilated pupils
• Slow pulse

How Is a Traumatic Brain Injury Diagnosed?

A physician will first look for the most obvious symptoms to diagnose traumatic brain injury. A head ultrasound, magnetic resonance imaging test (MRI), or computed tomography head scan (CT) is typically performed if they are present. These imaging tests evaluate for skull fractures and brain abnormalities.

A head ultrasound is generally the first test administered because it’s more readily available. They also take less time to complete and are less invasive when compared to MRI or CT scans. Although more time-consuming and intrusive, MRI produces a more in-depth image of the brain.

Treatment Options for TBI

There are currently several treatment options for traumatic brain damage. Although it may not stop cerebral palsy from developing, it can give the infant a better chance of survival and fewer complications as they grow older.[2]

Treatment options include:

• Surgery to repair fractures, remove blood clots, and drain accumulated fluid
• Mechanical ventilation assistance to help reduce brain swelling and the amount of damage
• Therapy, including physical, occupational, speech, and alternative therapies
• Adaptive equipment
• Medications

What Is the Prognosis for a Baby with Traumatic Brain Injury?

Since traumatic brain injuries are so complex, it’s difficult for doctors to determine the infant’s prognosis. Sometimes, it takes months and even years to establish a long-term outlook.

The prognosis will depend on how severe the brain damage is and how well the child responds to treatment. If the child is diagnosed with cerebral palsy, they will live with the condition for life. However, the good news is that cerebral palsy doesn’t worsen over time, and many children thrive if provided with the proper treatment.