Paediatric traumatic brain injuries present some of the most complex challenges in medico-legal work, especially when assessing causation, liability and long-term outcomes. In this expert-led webinar, Consultant Paediatric Neurosurgeon Mr Ibrahim Jalloh shares real-world clinical and expert witness insights to support solicitors working on catastrophic injury and clinical negligence claims involving children.

Mr Ibrahim Jalloh is a Consultant Paediatric Neurosurgeon with specialist expertise in traumatic and congenital brain and spinal conditions. He regularly provides expert witness reports in complex medico-legal cases involving catastrophic paediatric injury. His clinical practice includes the management of hydrocephalus, spina bifida, Chiari malformation, spinal cord injury, and brain and spinal tumours.

• How paediatric brain injuries are assessed and managed in both acute and long-term care

• Clinical considerations in cases involving hydrocephalus and delayed recognition

• What to expect from expert witness reports in paediatric neurosurgery cases

• Key factors influencing causation and prognosis in catastrophic child injury claims

• What solicitors should look for when reviewing neurological evidence in support of high-value claims

Watch the full webinar below:

Accurately assessing traumatic brain injuries in children is often complex – yet these injuries can have lifelong consequences for a child’s development, cognitive function, care needs, and overall quality of life. These outcomes directly shape quantum assessments, causation arguments, and the strength of your medico-legal position.

Neurosurgical expert evidence is therefore essential in clarifying the mechanisms of injury, establishing timelines for intervention, and supporting accurate projections for future care. In this webinar, Mr Ibrahim Jalloh underscored the importance of understanding both the acute and long-term impacts of paediatric brain injury when building high-value litigation strategies.

This session offered valuable clinical and practical insight for solicitors working on complex paediatric brain injury cases. Below is a deeper dive into the key takeaways that can strengthen medico-legal arguments and inform your approach to both causation and quantum.

1. Children are not “small adults” in TBI cases.
   Mechanisms of injury, biological response, and diagnostic thresholds differ significantly in children. Solicitors must be aware that adult TBI frameworks cannot be applied to paediatric claims.

2. Missed imaging is a recurring medico-legal issue.
   Mr Jalloh presented multiple case examples where failure to scan despite focal neurological symptoms (e.g. limb weakness, repeated falls) led to delayed diagnosis of spinal cord or intracranial injury. Breach of NICE guidelines in such contexts can be legally significant.

3. TBI often masks underlying spinal cord injuries.
   There’s a known association between paediatric head injury and high cervical spine trauma. This is frequently overlooked at the initial stage. Claimants with delayed spinal diagnoses often suffer more complex outcomes.

4. Secondary injury is often preventable – and legally relevant.
   Outcomes worsen significantly when secondary injuries like hypoxia or raised intracranial pressure aren’t managed quickly. Solicitors should interrogate ambulance, ED, and ICU records for lapses in early intervention.

5. Failure to transfer to a Major Trauma Centre may constitute breach.
   Mr Jalloh noted that treating paediatric TBI in specialist centres leads to better outcomes. Failure to follow this pathway can increase liability exposure – a point relevant for ambulance service claims.

6. NICE head injury guidelines are essential – and not followed consistently.
   There is strong emphasis on adhering to NICE protocols for when to scan, how to manage neurological deterioration, and when to escalate. Solicitors should always cross-reference decisions against guideline criteria.

7. Long-term outcomes extend beyond mobility.
   Solicitors must consider and evidence deficits in:

   • Cognitive and language development

   • Endocrine function (pituitary damage causing fatigue, delayed puberty, growth issues)

   • Emotional regulation and autonomic dysfunction (dysautonomia)

8. Epilepsy risk continues for decades.
   Risk of post-traumatic epilepsy remains elevated for up to 20 years post-injury, with medico-legal implications for future care and life expectancy.

9. Birth-related trauma and subdural haemorrhages require nuanced assessment.
   Non-accidental injury (NAI) claims or defences must involve careful analysis of neuroimaging, fracture patterns, and alternative diagnoses like BESS (benign enlargement of subarachnoid spaces).

10. Developmental impact may not show for years.
    Meaningful neuropsych assessments often can’t be performed until age 5+, making early settlement of some paediatric claims risky. Lifelong care projections must consider delayed cognitive decline.

This case discussion draws on insights shared during a live webinar by Consultant Paediatric Neurosurgeon Mr Ibrahim Jalloh.

Mr Ibrahim Jalloh, MB ChB, MRCS, FRCS (Neuro.Surg), is a leading Consultant Paediatric Neurosurgeon based at Cambridge University Hospitals NHS Foundation Trust. He specialises in the management of traumatic brain and spinal injuries in children, as well as congenital conditions including hydrocephalus, spina bifida, Chiari malformation, and paediatric brain tumours.

Mr Jalloh also has significant expertise in advanced neuromonitoring, cerebrospinal fluid (CSF) disorders, and neurotrauma surgery. He regularly provides expert witness reports in high-value clinical negligence and catastrophic injury claims involving children.

Mr Jalloh accepts medico-legal instructions for both paediatric and adult neurosurgical claims relating to brain injury, spinal injury, surgical complications, and delayed diagnosis.

For medico-legal enquiries or to request his CV, Mr Jalloh can be reached at ibrahimjalloh@inneg.co.uk.