Traumatic Brain Injury (TBI) Program

Every parent knows how scary any head injury can be. From a minor bump to a major sports injury, families want peace of mind that their child will heal, grow, and thrive. We share this goal at the CHOC Traumatic Brain Injury (TBI) Program. With top-level inpatient and outpatient services and a level-one trauma center, our multidisciplinary TBI program offers patients care to optimize recovery after a head injury, all under one roof.

Our TBI program began when CHOC saw a need to expand our brain injury services beyond our existing concussion program. We bring together pediatric doctors and other medical specialists across neurology, neurosurgery, neuropsychology, sports medicine, physical medicine and rehabilitation, and primary care to provide treatment for any head injury seen in Orange County children.  

Understanding TBIs in Children

A traumatic brain injury, often called a TBI, happens when someone experiences a significant hit to the head. These injuries can happen when a child has a sports-related incident, fall, or other accident. The impact can cause brain damage ranging from mild to severe  traumatic brain injuries.  

While concussions, also called mild TBIs, are the most common type of TBI seen in children and typically do not have signs of injury visible on clinical imaging tests, some child with heady injury may have positive findings on imaging. Such findings may include  contusions (bruise-like injuries to brain tissue), diffuse axonal injuries (damage to nerve fibers within the brain), and hemorrhage (bleeding) within or around the brain. While physicians often recommend at-home treatments for mild injuries, more severe cases can require specialized treatments, therapies, and procedures to help with healing and to avoid complications. 

When properly diagnosed and treated, many patients will fully recover from TBIs. It’s important for families to quickly seek and receive medical care from a pediatric TBI specialist.  

Traumatic Brain Injuries We Treat

  • Concussion 
  • Mild Traumatic Brain Injury (mTBI) 
  • Complicated Mild Traumatic Brain Injury  
  • Moderate TBI 
  • Severe TBI 
  • Persistent Post Concussive Symptoms  
  • Post Traumatic Headaches 
  • Autonomic Functions 
  • Neurocognitive Problems 

Why Choose CHOC?

The CHOC TBI program aims to builds families’ confidence throughout their child’s brain injury recovery. Our program offers complete treatment plans by bringing together medical professionals, including: 

As our program grows, we look to increase the number of clinicians, specialties, and locations we offer. We’re also dedicated to building relationships with schools, sports organizations, and families throughout Southern California to teach the community about traumatic brain injuries in kids.    

What to Expect at the CHOC TBI Program

TBI Diagnosis at CHOC

While most patients come to our program from a physician referral, a parent or caregiver can ask for a consultation. During this first 90- to 120-minute consultation, your family will meet with a team of experts. 

While every child’s case differs, consultations usually involve a neurological exam, symptom sceening, and a brief neuropsychological assessment. Children are typically evaluated by a neurologist and a neuropsychologist at the initial visit.. More complex cases may also require advanced imaging with an MRI or neurodiagnostic studies ( EEG,) often to capture better pictures of the brain and evaluate for possible seizures, respectively. In select cases, other testing may also be recommended.  

After the doctor diagnoses your child’s injury, their care team will create a treatment plan. The treatment plan will include educating patients and families about what to expect next, such as further testing, possible treatment plan updates and ongoing recovery.  

TBI Treatment at CHOC

For mild head injuries, outpatient treatment is usually recommended. While most outpatient treatment plans recommend a brief period of rest and observation as the brain heals, they can also include medications, nutritional supplements, at-home exercises, rehabilitative therapies, accommodations for school, and technologies like neuromodulation.  

For more severe TBI cases, inpatient management is usually often necessary immediately after the injury and some patients may benefit from an extended inpatient rehabilitation program.  

Children with traumatic brain injuries benefit from our seamless collaboration across pediatric disciplines. Together, we’re able to serve every child’s unique TBI recovery with specialized care for headaches, vision changes, dizziness, physical mobility, sleep issues, attention and memory problems, mental health challenges, and more. 

TBI Recovery at CHOC

After treatment ends, our TBI care team will follow up with your child and family to ensure ongoing recovery. Your child’s recovery plan may include recommendations to help with ongoing symptoms, timelines to return to normal activities, and how to avoid future head injuries. If your child is an athlete, their doctor may conduct baseline testing to measure current brain health before they are cleared return to sports 

See a CHOC Traumatic Brain Injury Expert

Connect with the CHOC Traumatic Brain Injury program today to learn more, schedule a consultation or refer a patient to our clinic. 

Frequently Asked Questions about Traumatic Brain Injuries

A concussion typically refers to a mild traumatic brain injury (mTBI). The term TBI is the umbrella term that covers all traumatic brain injuries, from mild to very severe. In short, all concussions are TBIs, but not all TBIs are concussions.
Minor head injuries in kids may cause a short loss of consciousness or confusion, mild headaches and dizziness, along with other symptoms. Severe head injuries can cause longer spans of unconsciousness and are more likely to have structural injuries seen on imaging such as bleeding in the brain or swelling. Always seek immediate medical attention for any head injury, as symptoms can worsen quickly.
As every child’s injury is different, there is no single way to know when a child should stop playing a sport after multiple concussions. Instead, parents and caregivers should talk with a doctor specializing in concussions and TBIs to make a recommendation.
While short-term issues are common, most kids fully recover from a concussion without permanent brain damage. However, repeated or severe concussions can make the risk of long-term neurological problems more likely. By visiting your doctor after a head injury and following their recommendation, you can help your child avoid long-term problems.
Sometimes, symptoms from a head injury happen right after an incident. They can also take hours or even one or two days to appear. How severe those symptoms are can be very different and range from mild symptoms like headaches and dizziness to more severe issues like confusion, memory loss, or loss of consciousness. Parents must closely monitor their children after any head injury for any changes in their behavior or physical condition. Seek medical attention if new symptoms begin to appear or existing ones worsen.
Most children have a full recovery after mild TBIs and will not have any permanent brain damage. Some children may also have a complete recovery after a more severe TBI while others may have an irreversible injury. It is important to discuss your child's unique case with their doctor and ask questions about what to expect in the long term.

Meet the Team

Romain, Jonathan E. PhD

Specialties: Neuropsychology, Psychology
Appointments: 714-509-8481

Dr. Jonathan Romain, PhD, is a board-certified clinical neuropsychologist who sees kids and teens at CHOC Hospital in Orange.

Linden, Michael PhD

Specialty: Psychology
Appointments: 949-489-3233

Dr. Michael Linden specializes in psychology and treats kids and teens in Orange County. He has privileges at CHOC at Mission Hospital.

Pearson, Rachel P. MD

Specialty: Neurology
Appointments: 888-770-2462
Office: 714-509-7601

Dr. Pearson is a neurologist with special qualifications in child neurology who treats kids and teens in Orange County.

Pichon, Pilar D. MD

Specialty: Neurology
Office: 714-509-7601

Dr. Pilar Pichon is  board certified in child neurology at CHOC in Orange County, California. 

Patient Stories

Smiling Rylee holding three months seizure free sign
Despite her happy disposition, Rylee had a big roadblock: frequent seizures. Six months past her epilepsy surgery, she hasn’t had a single seizure.

Maddy with pediatric neurosurgeon, Dr. William Loudon
At just 6 years old, Madison Morrison has earned the nickname “Miracle Maddy” after recovering from life-saving surgery at CHOC.

Smiling Michelle in bed with stuft toy
Before she was born, Michelle was diagnosed with microcephaly and encephalocele. Today, she’s thriving.

Team Miranda in the CHOC Walk at the Park in 2017
Inspired by her experiences at CHOC, this former patient is planning to major in psychiatry and dreams of becoming a pediatric optometrist.