Introduction

When a child wakes up after a coma, they may feel confused, disoriented, or have trouble remembering things. This is called post-traumatic amnesia (PTA) and is a common part of recovery after a traumatic brain injury (TBI).

Most children recover from PTA, even after a severe injury.

Children with PTA may:

• remember things from before the injury, but not after
• forget day-to-day events, like who visited them in hospital
• be unsure of where they are or what time it is
• seem confused about what is happening
• have trouble with memory and attention
• be restless or agitated
• repeat questions
• have changes in mood and behaviour.

PTA can last for hours, days or weeks. A longer period usually means a more serious injury:

• less than 24 hours – mild TBI
• 24 hours to seven days – moderate TBI
• more than seven days – severe TBI.

Diagnosis

Doctors use special tools to measure PTA:

• The Sydney Post-Traumatic Amnesia Scale (SYPTAS) – five orientation questions for children aged 4 - 7 years.
• The Westmead PTA Scale – seven orientation questions and five memory items for children seven years and over. 

Your child is usually out of PTA when they score full marks for three days in a row.

Once this happens, their rehab team can do more detailed checks of the brain injury and start treatments where your child uses their memory.

PTA treatment depends on your child’s needs. A calm and consistent environment helps with recovery. 

This can include:

• avoiding loud or busy places
• limiting visitors to one or two at a time
• keeping the room quiet, with familiar items and photos
• avoiding screen time
• speaking slowly, calmly and clearly and slowly to your child, repeating things if needed.

If your child is agitated or climbing out of bed, a mattress can be placed on the floor for safety.

Your child’s treatment team will guide you through this stage and tell you when your child can return to daily activities.

A positive thing is that most children do not remember this stage. Some small memories may return, but most of the time are usually forgotten.