Brain & Spine Trauma in Children
When a child suffers a serious injury to the head or spine, every minute matters. Trauma to the brain or spinal cord is the leading cause of death and long-term disability in children over the age of one — and the decisions made in the hours immediately following an injury can have a profound and lasting impact on a child’s outcome.
At Advanced Neurosurgery Associates, our team provides expert neurosurgical evaluation and treatment for children with brain and spine trauma across four New Jersey locations. We work closely with emergency medicine teams, pediatric intensivists, and rehabilitation specialists to deliver coordinated, comprehensive care from the moment of injury through recovery.
How Pediatric Trauma Is Different
A child’s brain and spine are not simply smaller versions of an adult’s. The developing nervous system has its own unique anatomy, biomechanics, and injury patterns that require specialized knowledge to diagnose and treat correctly.
Children’s skulls are thinner and more pliable, their brains have higher water content, and their spinal columns have significantly more flexibility than adults — all of which change how injuries occur, how they appear on imaging, and how they should be managed. Misdiagnosing or undertreating a pediatric neurotrauma can lead to outcomes that are entirely preventable with the right specialist involvement.
Types of Brain Trauma We Treat
Traumatic Brain Injury (TBI)
The umbrella term for any injury caused by an external force to the head — from falls and sports collisions to motor vehicle accidents. TBI ranges in severity from mild to severe and can involve a combination of the injury types below. In children, TBI is the single most common cause of acquired disability.
Concussion
A mild form of TBI caused by a sudden jolt or impact that temporarily disrupts brain function. It is the most common brain injury in children and is frequently associated with contact sports, bicycle accidents, and falls. While most children recover fully, repeated concussions or improperly managed recovery can lead to prolonged symptoms and cumulative neurological effects. ANA evaluates children with concussion to rule out more serious injury and guide safe return-to-activity.to surrounding brain structures.
Skull Fractures
A skull fracture occurs when the bone of the skull breaks under the force of an impact. Linear fractures — clean breaks without displacement — are the most common type in children and often heal without surgery. Depressed skull fractures, where bone fragments press inward toward the brain, and basilar skull fractures at the base of the skull are more serious and may
require surgical intervention to prevent damage to underlying brain tissue.
Epidural Hematoma
An epidural hematoma occurs when blood collects between the skull and the outer protective membrane of the brain (the dura mater), typically after a skull fracture tears an underlying artery. This type of bleeding is disproportionately common in children and adolescents. It is a surgical emergency — rapid evacuation of the hematoma is often necessary to relieve dangerous pressure on the brain before permanent damage occurs.require surgical intervention to prevent damage to underlying brain tissue.
Subdural Hematoma
A subdural hematoma forms when blood collects between the dura and the surface of the brain, usually from torn bridging veins following an acceleration-deceleration injury. Subdural hematomas can be acute, developing within hours of an injury, or chronic, accumulating gradually over days to weeks. Both require careful neurosurgical evaluation and, in many cases, surgical drainage.
Diffuse Axonal Injury (DAI)
A subdural hematoma forms when blood collects between the dura and the surface of the brain, usually from torn bridging veins following an acceleration-deceleration injury. Subdural hematomas can be acute, developing within hours of an injury, or chronic, accumulating gradually over days to weeks. Both require careful neurosurgical evaluation and, in many cases, surgical drainage.
Types of Spine Trauma We Treat
Cervical Spine Injuries
The cervical spine — the neck region — is the most commonly injured area of the spine in young children. Because children under age 10 have proportionally larger, heavier heads relative to their bodies, the upper cervical spine bears the greatest mechanical stress during trauma. Injuries range from ligamentous sprains to fractures and dislocations that may compromise spinal stability and cord function.
Spinal Cord Injury (SCI)
Damage to the spinal cord itself can result in partial or complete loss of motor function, sensation, and autonomic control below the level of injury. Prompt surgical decompression and stabilization, when indicated, are critical to maximizing neurological recovery. Our team coordinates closely with pediatric rehabilitation specialists to support the full continuum of care.
SCIWORA
Spinal Cord Injury Without Radiographic Abnormality — a phenomenon unique to children in which spinal cord injury occurs despite normal-appearing X-rays and CT scans, due to the exceptional flexibility of the pediatric spine. MRI is essential for diagnosis. SCIWORA is frequently missed without a high index of clinical suspicion, making pediatric neurosurgical expertise critical in its evaluation and management.
Vertebral Fractures
Fractures of the spinal column vertebrae can range from stable compression fractures that heal with immobilization to unstable burst fractures that threaten the spinal cord and require surgical stabilization. Mechanism of injury — falls, sports, motor vehicle accidents — heavily influences fracture pattern and treatment approach in children.
Diagnosis
Rapid and accurate diagnosis is the foundation of effective trauma care. Depending on the nature and severity of the injury, our evaluation may include CT imaging for immediate assessment of bleeding and fractures, MRI for detailed soft tissue and spinal cord evaluation, and neurological examination to assess the extent of functional impact. Our team is experienced in interpreting pediatric neuroimaging, where normal developmental variations can be easily confused with injury findings.
Treatment
Treatment is determined by the type, location, and severity of injury, as well as the child’s overall clinical condition. Options range from close observation and medical management for milder injuries to urgent surgical intervention — including craniotomy for hematoma evacuation, surgical decompression of the spinal cord, and spinal stabilization procedures — for more critical cases.
Every child treated at Advanced Neurosurgery Associates receives an individualized care plan developed in collaboration with the full clinical team and communicated clearly to the family at every step.
Caring for NJ Families When It Matters Most
We understand that a traumatic injury to your child is one of the most frightening experiences a family can face. Advanced Neurosurgery Associates has four offices across New Jersey — in Rutherford, Jersey City, New Brunswick, and Morristown — and our surgeons are experienced in managing the most complex pediatric brain and spine trauma cases.
Whether you are seeking a second opinion, a post-acute evaluation, or urgent neurosurgical consultation, we are here.
Brain & Spine Trauma Care Across New Jersey
If your child has sustained a head or spine injury and you need expert neurosurgical evaluation, contact us today.