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Courtesy of the Napadano family
Sam Napadano spent months learning how to talk and walk again after he suffered a traumatic brain injury during a motocross accident three years ago when he was 13.
Mark Napadano watched in horror as his 13-year-old son slammed head first into the hard ground after a motocross accident. In seconds he was at the side of his son, Sam, terrified by the sight of the junior high athlete so full of life just moments before lying limp in front of him - and not breathing. “It was like a nightmare,” Mark remembers.
At the hospital doctors examined Sam and gave Mark the frightening news: Sam had a large pocket of blood pooling near the top of his head and two smaller bleeds in the front and two in the back. “They didn’t say he was going to die, but they didn’t say he was going to live,” recalls the 45-year-old car dealer from Butler, Pa.
Sam was in a coma for days and in critical care for almost a month. By the time he was released to a rehab facility the 5-foot-4-inch teen had dropped from a trim and muscular 114 pounds to just 84. For months Mark and his wife, Sue, watched as their son learned to talk and walk for a second time.
Now, three years after the wreck Sam is almost back to where he was before, Mark says. Sam returned to school three months after the accident and kept up his rehab for two years. He still has some short term memory problems and though his working memory has improved, it can be a challenge if too many commands are thrown his way at the same time.
While conventional wisdom is that children have a great capacity to overcome damage from a severe traumatic brain injury, or TBI, because their brains are still developing and “plastic,” a new study shows that many may actually end up with some lasting deficits. The study followed 56 children for 10 years after they’d sustained a TBI between the ages of 2 and 7.
During the study, the Australian researchers repeatedly examined the children’s intellectual abilities, as well as social and behavioral skills, according to the report published in Pediatrics.
The report confirmed earlier research showing that most kids with mild TBIs recover completely, but the prognosis for children with more severe injuries is less predictable.
These new data suggest that “the majority of these kids will have long-term problems,” says the study’s lead author Vicki Anderson, a researcher at the Murdoch Children’s Research Institute in Melbourne. “And while there was some ‘spontaneous’ recovery, those who had access to rehab did better.”
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Three years after his accident, Sam Napadano, now 17, still has some short-term memory problems, says his father, Mark Napadano. "I tell people that he's 80 to 90 percent back to where he was," he says.
Anderson and her colleagues found that kids did continue to improve for years. “It appears that, after a protracted recovery period, these children gradually stabilize and begin to make some developmental gains, suggesting that even many years post-insult, intervention may be effective,” they write.
What researchers like Anderson can’t say is which kids will recover best after a severe injury.
“It’s difficult to predict outcome,” Anderson explains. “But a quality home environment and access to ‘appropriate’ rehabilitation is critical to maximize outcomes.”
The new research echoes Dr. Douglas Smith’s experience. “Kids do recover better than adults,” says Smith, director of the Center for Brain Injury and Repair and professor of neurosurgery at the Perelman School of Medicine, University of Pennsylvania. “And the younger [kids] tend to do better than the older ones. That’s because the younger you are the more plastic your brain is. That makes it easier for the brain to rewire.”
The most important factor impacting recovery is the type of brain injury, Smith says. If the injury sites are isolated the prognosis is better than if the whole brain is involved, with connections everywhere being twisted and ripped.
For Dr. Christopher Giza, an associate professor of pediatric neurology and neurosurgery at the University of California, Los Angeles, the study raises “a hopeful note that suggests that these kids are still able to advance and develop. And it may suggest that even a long time after the injury there is room for intervention.”
One of the reasons that researchers have assumed that kids are resilient enough to recover from severe TBIs is the many examples of children with epilepsy who have had large parts of their brains surgically removed – and have still gone on to live normal lives because the remaining brain rewired to take over the job of the regions that were removed.
The difference between that scenario and the aftermath of some TBIs may be explained by the fact that a TBI can hurt cells all over the brain, making rewiring difficult.
Q&A: Concussion crisis often a game changer, authors reveal
When it comes to severe TBIs in kids, parents need to realize that their children may require long-term rehab, says Mandeep Tamber an assistant professor of pediatric neurosurgery at the University of Pittsburgh School of Medicine and the Children’s Hospital of Pittsburgh. That rehab will help the brain to continue to rewire and also help the child to come up with strategies to compensate for lasting problems like short term memory deficits, Tamber says.
That makes sense to Ryan Bradley’s dad.
Three years ago, Ryan climbed up on the roof of a three story building with some friends and slipped, falling nearly 40 feet to the cement floor of a carport. Along with a host of other serious injuries, 11-year-old Ryan suffered a severe TBI.
Like Sam Napadano , Ryan spent days in a coma and then years in intensive rehab. He had to learn to walk and talk again. And today most of the injuries to the Santa Monica boy’s body have been repaired, but the damage to his brain has left some lasting deficits.
He’s in high school now, but needs accommodations to make it through the course work.
“There is a program tailored to him,” says Ryan’s dad, Kevin Bradley, 48. “He gets tutoring and teachers know that he sometimes needs longer on tests and breaks during the day.”
Ryan is working towards graduation and plans to go to college, but he will likely have to battle the lingering effect of the brain injury every day of his life.
“There are always some processing issues,” his dad says. “He gets a little information overload at times. He’s learned techniques to help him take better notes. He has techniques to help him be prepared for class.”
Kevin Bradley’s advice to parents with kids who’ve suffered a brain injury is simple: “Don’t give up hope. Be involved with your child’s care."
Do you know someone who has battled to come back from a severe brain injury? Tell us on Facebook.
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Another remarkable discovery.......Brain injuries can can cause long lasting defects ? Really ?
You missed the point. Probably trying to rush and get the first comment. The article is explaining why some injuries do not heal after time. The brain can rewire itself when just a part of it is hurt. This articles explains that in certain injuries, the whole brain is affected and the rewiring does not work as well. Instead of assuming the brain will rewire itself, the article suggests that certain injuries can benefit from long term therapy.
At least that was my take away.
For years we have been hearing that the brain does not really heal itself and now we have a study that tells us....the brain doesn't really heal itself. Wow!
That is the point. . .both you and PV' are correct.
I'm an EMT and it makes me wild that so many EMTs are so cavalier about TBI's. So what if there's not CSF fluid leaking out the ears? That doesn't mean it's not serious. I take the position that every thunk on the head is serious until proven otherwise.
13 Year old gets injured in a "motocross" accident? I have been to these events and participated in them. I will never understand why parents let their children do these dangerous things. My kids wanted to, but I never let them do it until they were 18 years old. Guess what? So far (knock on wood) they have shown maturity in the way they participate. They are just as good at this sport at their current age, as they would have been had they began at 13.
I so agree with you James. I don't understand these young children participating in dangerous sports. Just read another post about a 16 year old hockey player now paralyzed. I don't understand this risk-taking with your children. It is up to the parents when they are that young. They are not strong enough to do these things to begin with. If the child, at maturity wants to take these risks, they are at least better able to make a decision. Wow, I just feel so sorry for this young man.
I would agree with you but it is just part of a kid being a kid. When we was little there was all kinds of sports that we played only difference is that they have been amped up to an extreme level. Our kids need to have fun, I wish that there was a way to take the danger out of sport but there isn't and never will be. I love my kids to death but i'm not going to let them sit on the couch the become another overweight kid in this country. It is sad whats going on with these kids but let them have fun.
Take the article for what it is. A young man has an accident and he isn't the same. I have first hand experience with this. My brother mangled his body and had a severe concussion in an ATV accident. Years later after his body healed he began to have seizures. The seizures were so bad he had brain surgery. The seizures aren't as frequent as they used to be and my brother is not the same person as he was before the accident. Head injuries are serious business.
I had a severe TBI many years ago at age 17. Before the accident, I had been tested at reading 1200 words per minute with 85% comprehension.
After the accident, I completely lost the ability to string together more than three words. I could read one, then add a second and then add a third with comprehension. But adding a fourth word collapsed the entire string. An interesting dilemma.
Six months after the accident, I could suddenly read again. And after a few months I was retested at 1200 words per minute with 90% comprehension. So the brain can rewire itself after a severe TBI!
You'll likely find that you've lost some ability in other areas. I had a TBI eight years ago or so and I still have significant memory loss, both short and long term. The oddity of my injury is that I can remember entire conversations to the word from years ago (even unimportant ones) but I can't tell you what somebody said minutes or seconds ago.
We have a lot to learn about our brains.
I'm glad that kid recovered.
On the other hand, this might explain a few things about me as a kid.
Where's the jokes about how we knew that all along because of <insert politician here>?
This really is a story about what we already know and have known for many years. ADHD in the 1800's or earlier was caused Post encephalitic syndrome as the brain damage caused by high fever and sometimes brain swelling caused symptoms of what today we call ADHD. Post concussive syndrome and Traumatic Brain Inmnuries will always cause long term problems from very mild to significant. Those with these types of inures are also more likely to have early onset dementias.
Did he have a helmet one? A friends son was on his skateboard heading down a steep hill: he did not have his strap on his helmet--age 15 a heathly young man---never recovered. Same thing with those who think they are flying on motor cycles...the ones who didn't have one when they were a teen--now especially age 40-65+ think they are still flying and they doo.....while their skin peels off onto the pavement!
Brain injury+emotional or physical abuse = drug and alcohol addiction + narcissitic sociopathic psychosis + statistical probability of criminality and murderous behavior. Sorry it sucks to be some of you. Too bad we only know it until after you are caught or kill yourself and you leave a note. I wish we could have caught your parents or caregivers, this type of behavior is all to often a learned response.
Actually, TBI's are likely to lead to depression, which then triggers the cycle of drug/alcohol abuse. Many psychiatrists fail to ask their patients if they've previously had any injury to their head or have been unconscious. Patients who have seem not to respond to antidepressant medications as well and are more likely to struggle with some level of depression for years.
during the 1930s my mother experienced a serious fall down a flight of stairs as a child; not longer thereafter she seemed to be slower learning new things and some time after that began to suffer seizures. she never knew there was injury to her brain because back in her day there were no MRIs, PETs, etc. her family had no clue what to do and because she seemed "okay" they never really had her examined by a doctor. years later she did have an MRI and the doctors found scarring to her brain.
The brain is a fragile organ...not like a liver or kidney. Yet there may be breakthroughs that can help severe TBIs in the future, assuming we still have the science. Europe and Asia are the hotbeds of research now, and our country has fallen behind. Otherwise, why are Kobe and Payton going overseas for medical treatment?
I wish the best for these families...they and their kids got a second chance, and while it may be a rough road, at least they will be there to travel it. Life is short and precious, and we only live it once.
Jaedor- Thank you. You give us hope. To the others with negative comments sorry you feel the way you do. I guess you have to walk a mile in someone elses shoes before leaving some of the comments some of you have left. I wish I could live to be perfect in your eyes.
in 2005 a tree fell on my daughter. it cracked her skull from front to back. she was not breathing when my husband pulled her from under the tree. to this day, we see many problems that are an effect of this, but she is a healthy vibrant 17 year old now. the doctors have no answer as to how she survived this horrible event and is thriving. some things cannot be explained medically. and the problems she does have now are problems we welcome with open arms because that day, we lost our daughter and she was miraculously given back to us for a second chance at life. she has many social delays, and some learning disabilities that make her slower than her peers at school, but to look at her, you could never tell what she went through. we know she will always be effected by this event in her life, in many ways. but we never question why this had to happen to our daughter, to our family. and as horrible as it was at the time, i truly believe that everything happens for a reason. the body and the brain is a mystery.
"Kids' brain injuries can cause lingering problems for years, study finds"
It doesn't get much more intuitive than that, does it? You can leave the word "Kids" off of it and it's still factual.
"Kids' brain injuries can cause lingering problems for years, study finds"
It doesn't get much more intuitive than that, does it? You can leave the word "Kids" off of it and it's still factual.
Traumatic brain injuries are the loudest silent epidemic. Center for BrainHealth research has shown that there may be a cumulative impact of injuries and later emerging deficits may appear weeks, months and even years after the initial impact. Center for BrainHealth scientists are developing, testing and implementing effective programs to restore and repair brain function after injury and build resilience against injuries. Learn more about this unique, effective program at centerforbrainhealth.org.
I tried to get the schools to help brain traumatized kids, but the schools don't believe the problem exists.
Are these results a symptom/cause of current worldwide government regime and their questionable activities??
With all the money blown on worthless pointless wars in the middle East cant some funding help study treatments and for medical help for the brain-injured.. I had one and you can only imagine how much it affects every aspect of your life and the family around you. You can get better but you got to want it and do what it takes to make your goals happen.. keep hope..