By Melissa Jackson
BBC News Online health staff
Children who suffer any form of head injury may be at long-term risk of complications, including personality changes, research shows.
The effects of head injury can have lasting consequences
Parents often say the personality changes are so dramatic it is like having a different child.
In many cases the follow-up treatment for children with head injuries is poor, which affects their education.
A University of Warwick study recently found a third of parents thought their child's personality had changed.
More than 40% of children with mild head injury had behavioural or learning problems that led to them being described as having a "moderate disability".
Dr Carol Hawley, from the University of Warwick, said: "Many children with mild injury do not receive routine follow-up after discharge home from hospital, yet a significant proportion of them do have some lasting problems which may affect their behaviour and ability to learn.
"This could put them at a disadvantage at school."
Elaine Russell is a parent who knows too well the challenges of coping with a child recovering from a severe head injury.
Her experience and that of her daughter confirm latest research.
At the age of seven, her daughter Elisha was injured in a car crash. She was a back seat passenger.
She spent eight weeks in hospital.
When she regained consciousness, two weeks after the accident, she "was like a baby", said her mother.
"She couldn't walk, talk, feed herself or go to the toilet and doctors said she would have to start again from scratch."
Physiotherapists taught her to walk again and she received speech therapy.
For the first two years after the accident she had a series of out-patient appointments, which were cut back to six-monthly intervals as she got better.
Elisha, now 15, received good care and attention while the family lived in Leeds, but after moving to Bradford four years ago, the treatment has tailed off because it is not provided by the health authority.
Mrs Russell said: "Her physiotherapist is in Leeds, but we live in Bradford, but Bradford doesn't have any services whatsoever, so she doesn't get any support whatsoever.
"All her physio is private - we have to pay for her."
Her behaviour has changed in many ways.
Her mother said: "Before the accident, she would sleep for 13-hours at night, but after the accident, it got to the stage where I was having maybe an hour of sleep a night and that went on for months and months.
"She still has irregular sleep patterns - every night is different - sometimes she will be out like a light and other times she will be up until one or two in the morning."
Her general behaviour is very erratic.
Mrs Russell said: "Sometimes she will slam doors in people's faces and she has lashed out at me and her sister.
"She gets so frustrated with herself, she gets frustrated because she can't find the right word to describe something.
"She screams and shouts to let off steam.
"She was a very quiet child before the accident and wouldn't say boo to a goose, but now it can be like World War III.
"Her sister is 17 and I feel like a referee half the time."
Elisha has learned to walk again, but she has no road sense and no concept of danger so she needs to be accompanied at all times.
Mrs Russell said: "If she sees a friend across the road, she will just go after them without looking to see if any traffic is coming."
Elisha has the reading age, speech and language skills of an 11-year-old.
She has no physical disability, but she is way behind in her development and medical experts do not know if she will ever catch up.
Mrs Russell said: "When you tell people she has a brain injury, they say 'she looks alright'."
Her schooling has caused Mrs Russell some anxiety.
After they moved to Bradford, she switched to a local school.
Mrs Russell said: "They had no idea how to handle her.
"They put her condition down to behavioural problems but had no control over her whatsoever."
She was swiftly returned to her school in Leeds, where she is in a normal class, among her 15-year-old peers.
Mrs Russell feels she has had to fight for her daughter's treatment and since moving, has met with little success.
Her advice to other parents with children with head injuries is to "fight for everything".
Her older sister Andrea is now trying to set up a group for the siblings of children with head injuries because she feels they need to share their emotions and experiences with each other.
Her aim is to become a counsellor for the siblings of children with head injuries.
Meanwhile, Elisha is studying for GCSEs, which she will take next summer.
Even though teachers have predicted G grades - her mother is keen for Elisha to try to lead as normal a life as her condition allows.