A Sudden, Freak Accident (Traumatic Brain Injury)
A Loud Crash
There was no mistaking the crash. It came from the basement, followed by the frantic screams of 3-year-old Brandon.
His mother was upstairs cooking dinner, and she knew at once the crash had come from her husband's barbell set. She immediately pictured her son's tiny foot crushed beneath 150 pounds, but the sight that greeted her at the bottom of the stairs was far more alarming. Brandon was lying on the carpet, saturated with blood, with more blood pouring from a deep gash in his head.
He'd been hanging from one of the barbell's end poles when the weight bench began to topple toward him. He saw it coming and tried to run away from it, but the pole caught the left side of his head, just above the ear. The result was a 3/4-inch indentation to his skull.
"It was one of those freak accidents," his mother, Wendy, said. "He'd never been over by that thing."
Rushing to the Hospital
Wendy tried to stop the bleeding with a rag pressed to the wound while her husband, Stuart, rushed them to their community hospital. Doctors there re-routed them to the emergency room at Good Samaritan Regional Medical Center, where a pediatric neurosurgeon from Phoenix Children's would be available to assess the injury.
Brandon was quiet on the second leg of the journey, which wasn't especially reassuring to his parents. Fearing brain damage, they encouraged him to talk, but the unsettling silence continued.
"He would just look," Wendy said. "He was in shock."
A barbell injury was something new to the Barrow at Phoenix Children's neurosurgeon who met the family in the emergency room. As he noted the seriousness of the injury - Brandon was losing brain tissue through the wound - he tried to prepare the family for the possibility of permanent damage.
Since the injury was in the area of the brain's expressive speech zone, it was possible he would have speech problems - or he would not be able to speak at all. He could also have limitations in his motor skills, the physician warned. Still, the doctor wasn't entirely pessimistic.
"Children have a remarkable ability to adjust," he said. If a child injures a part of the brain that controls a particular function, the function can sometimes be transferred to another area of the brain. Since an adult does not have that ability, an identical injury could be devastating to an older person.
The neurosurgeon took Brandon into surgery to reconstruct the fractured skull, using four pins to piece the bone back together. He discovered that Brandon had lost a portion of his brain equal to the size of an ice cube, but he knew there was no way to determine the effects of the injury until the child woke up from surgery.
Brandon came out of the operating room with 16 staples and 10 stitches in his head, and his parents waited to see if he would recover fully. They were elated when he woke up and started talking.
"Everybody was so excited, because he could actually talk." His speech was a little slurred at first because of swelling, but by the second day he could speak normally again. Nurses periodically tested his motor skills, and found no problems.
"You would never know he had a head injury, except for his scar," his mother said. Even that is expected to disappear as he grows older.
As Brandon was discharged from the hospital, his parents were warned to keep their son calm and quiet, since a repeat injury could have serious results.
"We were so protective of him," Wendy said. "We just didn't let him out of our sight." He loves to run through their large home, so every time he starts to move he receives a fresh reminder from his parents: "Don't run."
Shortly after he returned home from the hospital, Brandon went back into the basement, pointed to the exercise station and said, "That's where I got my owie." He doesn't go near the equipment anymore - not that he's apt to be injured by it a second time, now that his parents have learned a hard lesson.
"The barbell remains on the floor," Wendy said.