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Child had a brain injury. Went through surgery and lumbar drain. Why are there headaches?

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Neurologist, Surgical
Practicing since : 1997
Answered : 65 Questions
Dear Doctor,

My Son had a brain injury at age of 5.5 yrs as he was struck by a brass pot. Since then he had been 6 months in ICU and went through Surgery, lumbar drain to normalize ICPs and now he is under Rehab. He had gone through several MRI's and CT scan. For past week he is having headaches daily for 30 mins , we are not sure why but they go off on there own.

I am sending his 2 MRI reports, one taken in month of Dec 2011 and one recently in April 2012. Please tell me condition of my son right now looking at MRI? will he ever get back to normal in some months. Why is having headaches/
Posted Wed, 23 May 2012 in Stroke
Answered by Dr. Shivakumar S. Kupanur 11 hours later

Thanks for posting your query.

I have gone through the short history and the MRI reports provided by you.

MRI report shows the chronic subdural collection. Daily headache of short duration may be due to this collection, over drainage of CSF (cerebrospinal fluid) if shunt is done or it can be part of post concussion syndrome which is expected after head injury.

He does not need any active intervention for headache. It will settle over the period of time. Currently, he needs only symptomatic treatment, physiotherapy and periodic MRI to monitor the subdural collection.

Your son's condition will definitely improve and he will return to normal, though exact time cannot be predicted. You need to have lot of patience.

I hope, I have answered your query. I will be available for follow up queries if any.

Above answer was peer-reviewed by
Follow-up: Child had a brain injury. Went through surgery and lumbar drain. Why are there headaches? 12 hours later
Hello Dr.

Thanks a lot for your reply that is very comforting , can these MRIs give any indication of when and if he will return to total normal physical activity. Right now he has weakness of the right arm and leg and is undergoing physical therapy , he is making progress but its very slow. We are hoping and praying for a full recovery , but I just wanted to know if it is possible to look at these MRIs and determine that he will achieve a hundered recovery and will be just as he was before the injury. He had his last surgery about 8 months back , came home and since then he has been undergoing physical therapies and regular MRIs.
He has regained a lot of functionality in his leg but his ankle is still very weak with some dorsiflexion , his hand and arm has been a concern for us since it is progressing very slowly. His extensor muscles are very weak and has a little bit of spasticity and fist clenching , he is able to open his hand and pick up things and his range of motion of the arm is almost 80% . But the overall arm is weak and he has difficulty in holding heavy things or moving his arm while walking .

I also have his entire history of MRI which I can share if needed.


Answered by Dr. Shivakumar S. Kupanur 18 hours later
Hello again
Thanks for writing back.

A MRI will not indicate functional recovery. It has to be assessed clinically. But, after going through the detailed history provided by you, I feel he should improve over next 6 months to 1 year time.

He must undergo intense physical therapy. Children usually do well in head injury compared to adults. They will have near total recovery unless there is any fresh complication, which is unlikely in your son's case.

Closely follow up with your treating doctor.

I hope this helps to solve your query. I wish your son a speedy recovery.

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