How to detect early brain injury More and more studies are proving the importance of early intervention, so what should we look for in early brain injury? Risk factors Pay attention to the presence of high-risk factors that cause brain injury: (1) prenatal factors: advanced pregnancy, viral infection during pregnancy, drugs, etc.; (2) intrapartum factors: premature birth, cerebral hemorrhage, cerebral hypoxia, etc.; (3) postnatal factors: nuclear jaundice, intracranial infection, traumatic brain injury, etc.; (4) the majority of high-risk children can grow and develop healthily, but about 10% will have brain injury, which is the most potential risk for high-risk children. Early detection of brain injury and early rehabilitation are the keys to protect the health of high-risk children and reduce the occurrence of disabilities. Development, movement, and posture: (1) irritability, constant crying or excessive quietness, weak crying, difficulty swallowing, vomiting, and slow weight gain; (2) hypotonia and reduced spontaneous movement; (3) stiffness, abnormal posture, and uncoordinated movements; (4) unresponsiveness, non-recognition, and inability to cry; (5) spasticity (6) delayed gross motor development, hand clenching, strabismus, etc. The vomiting reflex is a reflex that occurs in normal infants when the tester sticks his index finger in the infant’s mouth and touches the base of the tongue. This reflex continues throughout life. The vomiting reflex is a protection against choking on food in the trachea and may be lacking in infants with low muscle tone, so that liquid food can flow easily into the trachea. The opposite is true in hypertonic infants, where the reflex is so strong that touching the tongue with a finger, or even just the lips, will produce a vomiting response. Feeding such a child is more difficult. Hug reflex This reflex is seen in normal newborns and disappears after 3-4 months of age. It is not easily elicited in neonates with hypotonia and severe mental retardation. In children with unilateral palsy, this reflex is asymmetrical; if the hug reflex persists beyond its normal duration, it indicates that the infant has brain damage. Infants with hypertonic cerebral palsy may have a weakened hug reflex due to arm flexor spasm. The infant will turn its head in the direction of stimulation and make lateral movements with its mouth in an attempt to eat the finger. This reflex is normally present in newborns and disappears after 4 months of age. Lack of this reflex during the neonatal period is often indicative of a more serious pathology, and it is often consistently positive in children with cerebral palsy. Asymmetrical Tension Reflex When the infant is placed in the supine position and the tester turns the infant’s head to one side, the upper and lower extremities are extended on the side facing the infant and flexed on the other side. It is normal for this reflex to appear within 4-6 months of birth. If the reflex does not disappear after 4 months of age, it is pathological, and it may persist in children with spasticity and tardive dyskinesia. When this reflex is present, the entire body is hyperextended, the head is tilted back and to the side, the scapular girdle is contracted, the scapulae are brought together, the shoulders are abducted, the lower extremities are adducted, and the ankles are plantar-flexed. This reflex cannot be elicited in infants after 4 months of age. The persistence of this reflex is usually seen in children with spastic and tardive dyskinesia.