Traumatic brain injury occurs commonly. Yet it has attracted little study in childhood. It has been estimated that, in the US alone, each year about 75000 people sustain ‘new’ brain injury and are left with significant disability (Kraus, Fife & Conroy, 1987). Many of these brain injuries pertain to children. In the late 1970s as many as 90% of closed head injury victims may have died. Nowadays 90% survive (Gualtieri, 1990). Traumatic brain injury to the brain is one of the most common causes of death in childhood and a common cause of chronic brain syndromes in children. Neurological damage can occur for a number of reasons. Acceleration and deceleration of the brain within the hard bone structure of the skull can produce contusion of the nervous system and subarachnoid haemorrhage. Shearing stress may develop during acceleration and deceleration because of the different densities of different parts of the brain. Cerebral oedema is a common complication, as are infection and haematoma. The repair process itself can contribute to further problems, for instance by unsuccessful rewiring. It is essential that the clinician responsible for the work-up and treatment of young people with traumatic brain injury regard each case individually: there are many causes and processes involved in brain injury and the cognitive and psychiatric sequelae will vary in severity and type from one child to another. <Epidemiology

Childhood accidents are the most common causes of acute brain injury.