How to Prevent and Treat Head and Traumatic Brain Injuries at Holtz Children’s Hospital

Close up of woman smiling

By: Krysten Brenlla and Heather McCrea, MD, PhD

According to the Brain Injury Association of America, head injuries and traumatic brain injuries (TBI) are major causes of disability and death in children and adolescents in the United States. As we step into Brain Injury Awareness Month this March, we’d like to emphasize some of the causes of head injuries and TBIs in children, how to prevent them from happening, and how to treat them if they do happen.

Pediatric head injuries and TBIs  include injuries to the scalp, skull, and the brain. They can affect children differently depending on their age and the severity of the injury. According to the Centers for Disease Control and Prevention, the two age groups at greatest risk for head injuries are children ages 0 to 4 and 15 to 19.

Luckily, there are ways to prevent common head injuries. If your child has suffered a head injury or TBI, there are treatment options available at Holtz Children’s Hospital.

Learn more about head injuries, TBIs, prevention, and treatment options from Heather McCrea, MD, PhD, director of pediatric neurosurgery at Holtz Children’s Hospital, and a UHealth – University of Miami Health System pediatric neurosurgeon.

1. What are some of the most common head injuries you see at Holtz Children’s?

Dr. McCrea: We see head injuries and traumatic brain injuries from many different causes. For example, some are from children who were involved in motor vehicle accidents, or were hit by a car. Other causes are falls from significant heights, bicycle accidents, and sadly, gunshot wounds to the head. Gunshot wounds recently became the leading cause of death in the United States for children and adolescents.

2. What are some ways parents and children can prevent head injuries?

Dr. McCrea: The best thing parents can do to prevent injuries is to ensure that every time their young child is in a car, the child is safely buckled in a car seat. They should also make sure that they fully understand the instructions to properly secure the car seat in the car, and the child in the car seat, so that it is being used properly. Younger children should be in a rear facing car seat, which helps to avoid spinal cord injuries. Teenagers and adults should wear seatbelts at all times while in a moving vehicle. With these safety measures, the chances of head injuries in car accidents has dramatically decreased over the years.  Additionally, if a child is on a bicycle, scooter, or riding a horse, they need to be wearing a helmet.

3. What are some of the most common symptoms parents should look out for if their child has suffered a head injury?

Dr. McCrea: After head injuries, the things parents should be worried about are headaches, nausea, vomiting, drowsiness, or not acting normally. If the child lost consciousness after the initial injury, that is likely a more severe case, but even if they did not, symptoms like these suggest a need for evaluation.

4. What are some treatment options Holtz Children’s offers for children who have suffered head injuries or TBIs?

Dr. McCrea: It really depends on the type of injury. If the patient has a minor injury, then we will have them follow up with our concussion clinic to guide them on when they can return to school or sports. If the child has a more severe injury, including bleeding in the brain, they may need to be observed in the hospital or even undergo surgical intervention. With a large bleed in the brain, surgery can be lifesaving, so it is important to bring a child in for evaluation if they are having symptoms after a head injury or if the way the child was injuredeemed severe.

There are certain criteria our pediatric emergency room uses to evaluate the severity and risk of a head injury, and based on this they determine whether a child just needs to be observed or needs imaging.  If the imaging shows findings, then I get called to determine next steps of how to treat this injury. At Holtz Children’s, we have a fantastic team of pediatric ER doctors, pediatric surgeons, and pediatric ICU doctors who I work closely with to take care of our sickest head trauma patients.

Following safety measures like properly using car seats and helmets significantly reduces injuries, but there is always a possibility a child can get hurt. If a parent or guardian is ever concerned after a fall or accident, it is never the wrong answer to come in and get evaluated.

For more information about head injuries and treatment options available at Holtz Children’s, please visit our website at

Heather McCrea, MD

Neurological Surgery, Neurological Surgery Pediatrics