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patient name: Brayson Cosby

age: 6

condition: Traumatic brain injury

seen in: Level 1 Pediatric Trauma Center, neurosurgery

providers: Robert Lober, MD, PhD, FAANS


During an early September morning in 2022, the Cosby family was sound asleep in their home until the unimaginable happened. Their ceiling collapsed on top of them and a nail lodged into their 5-year-old son, Brayson's forehead.

Brayson was immediately taken to the nearest emergency department and then transported to Dayton Children's Hospital by the mobile intensive care unit. As the only Level 1 Pediatric Trauma Center in the region, Dayton Children's provides the best care for children, even in the toughest circumstances.

When Brayson and his family arrived at Dayton Children's, a team was already in place and waiting for them. They were quickly taken to a trauma room in the emergency department where they met Robert Lober, MD, pediatric neurosurgeon. Dr. Lober explained to the Cosby family that he was going to remove the nail from Brayson's head by performing a bifrontal craniotomy with a hairline incision.

Twenty minutes after arriving at Dayton Children's, Brayson was in the operating room with Dr. Lober. Over the next three hours, the Cosby family waited with anticipation until Dr. Lober came out to tell them that Brayson was recovering in the pediatric intensive care unit (PICU). He also explained that the surgery had been a long and extensive process. Dr. Lober and his team work diligently to stop the bleeding while also repairing cerebrospinal fluid leaks. 

preventing an infection

After surgery, one of the biggest concerns was Brayson developing an infection. In the PICU, Brayson's care team placed a peripherally inserted central catheter (PICC) line and started him on two strong antibiotics to prevent infections.

Brayson was discharged from the hospital five days after surgery. He went home with the PICC line and his mom, Kayla, was trained to administer his antibiotics and make sure his PICC line was working properly. A home care nurse also visited Brayson weekly to change his dressing and get bloodwork. 

One of the antibiotics caused Brayson to have a reaction 10 days after his surgery. Around the same time, he also developed a fever causing him to be admitted to the hospital for two days. After the allergic reaction and the fever, it seemed like the PICC line continued to cause issues. Brayson's mom, Kayla, was on the phone with Dr. Lober at least twice a day, troubleshooting ways to help Brayson.

The longer the PICC line caused issues, the more concerned Dr. Lober became. Fifteen days after surgery, Brayson's PICC line was removed.

After the PICC line was removed, Brayson remained under close observation. He has had a CT and MRI three different times after surgery to check for infection. Lucky for Brayson, he never got an infection because Dr. Lober started him on heavy antibiotics and stressed the importance of finishing them.

Although the antibiotics did their job to prevent infection, they also caused Brayson to have an allergic reaction known as vancomycin flushing reaction. Vancomycin flushing reaction is a reaction to specific antibiotics that causes a rash on the face, neck and torso, Unfortunately, this antibiotic was the only one strong enough to protect Brayson against infection, specifically Osteomyelitis, so Brayson had to take Benadryl before each dose.

"Dr. Lober saved our son's life. He is truly the most caring doctor I have ever met and puts his all into his patients' care." - Kayla Cosby, Brayson's mom

healing from trauma

Brayson now has a scar along his hairline from one ear, across his forehead to the other ear. He also has four titanium plates and 16 screws holding his skull in place.

Overall, Brayson is doing better. He attends sessions with his psychologist and uses medication management to help with the symptoms of his brain injury. Although he might have to take more breaks and be a little more cautious, Brayson still enjoys the activities of a typical 6-year-old boy! He's adventurous, loves to be outside, and more than anything, loves to ride his dirt bike.

The Cosby family has come to terms with the fact that their son is not the same. They take everything one day at a time and do their best to support and nurture Brayson as he navigates his new normal. 

"We are just grateful and so incredibly blessed that our son is still here," exclaimed Kayla. "We know the outcome could have been very different so when we look at Brayson, we see a walking miracle!"