TBI - BICYCLE RIDER

Bobby, a ten-year-old boy who did well in school, played football, and was in good health was riding his bicycle to visit a nearby friend. He didn’t see that a speeding car was heading in his direction, since it was behind him. The driver, who was legally drunk and speeding, rammed right into Bobby, throwing him to the pavement with force. Unfortunately Bobby was not wearing a helmet, and his head hit the pavement hard. In addition to his head injury, Bobby also suffered a broken wrist.

Nearby pedestrians came to Bobby’s aid as the driver sped away. Bobby was not conscious. An ambulance was called. By the time the emergency medical personnel arrived, which was approximately 10 minutes after the accident, Bobby was conscious but confused. He could not really say what had happened or what hurt him the most. His uncovered arms and lower legs were covered in road burns. His wrist was visibly deformed. He was transported to the hospital on a backboard with his neck immobilized and his wrist splinted.

In the emergency room, Bobby started to complain of pain. He opened his eyes on command. However he did not remember the accident or understand where he was. His parents were already there and authorizing treatment. After x-rays, it was determined that his neck was not broken, but his wrist was. Treatment of the wrist would be delayed until the severity of his brain injury was determined.

His Glasgow Coma Scale number was 13. Because of the loss of consciousness, and because he had other injuries, the doctors decided to do a CT scan. Bobby had a small contusion in his left temporal lobe, but no other visible problems on CT.

He was admitted for observation and necessary treatment. 24 hours later, he was alert and oriented. He complained of headache and wrist pain. The orthopedist was able to set his wrist fracture. Bobby was sent home and his parents were given thorough instructions about what to watch for.

He missed a lot of school because of headache and memory troubles. Homework was sent home to him, but he could not do math, and he had trouble remembering what he read. He also had trouble sleeping.

His bicycle had been wrecked, but he did not want another one. Bobby was able to return to school after a month, but his grades suffered. He was nervous and “not like himself.” He could not return to playing football on his return to school. His mother had to drive him back and forth to school since he would not ride a bicycle and was afraid to take the bus. His best friend could not understand the changes in his behaviour.

However, a year later, Bobby was pretty much back to normal. He was young enough to recover from what would be considered a minor TBI.

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