Head injury

Children often hit their heads and it can be difficult to distinguish when it is something serious.

For significant head bumps, always consult the paediatrician.

Most commonly head injuries cause only abrasions or cuts or a minor swelling. In some cases there may be brain damage. Go to the doctor immediately if:

  • The child is unconscious
  • The child has hit a hard surface, like after a fall from a height or in a car accident
  • The child doesn’t seem well and vomits

What are the symptoms of a serious head injury?

  • Loss of consciousness for more than 30 seconds
  • The child is lethargic and does not communicate with you
  • The child has serious signs of injury, like weakness in an arm or leg, unequal eye pupils
  • An object is left in its head
  • The child has had more than one seizure after the trauma
  • Blood or fluid is flowing from the nose or the ear

In these cases call an ambulance immediately.

What are the symptoms of a moderate head injury?

  • Loss of consciousness for less than 30 seconds
  • The child communicates with you
  • The child has vomited twice or more
  • The child has a headache
  • The child has had a minor seizure event immediately after the hit
  • The child has a large bump or hematoma

In these cases take the child to the hospital. It is likely that the child will need to be monitored in the hospital for 6-24 hours.

What are the symptoms of a light head injury?

  • The child has no loss of consciousness
  • The child communicates with you
  • The child has not vomited at all or just once
  • There is a small swelling or cut on the head or abrasions
  • The child has not had a seizure

In these cases inform your paediatrician. Put ice on the area with the swelling. If blood is flowing put a clean gauze and press steadily for 5 minutes.

During the next 24 hours, watch for the following in the house:

  • Headache. Give paracetamol regularly.
  • Vomiting. If  more than one, see your paediatrician.
  • Lethargy. Usually after head injuries children are drowsy or fall asleep. There is no need to keep the child awake. If the child falls asleep, wake her up every one – two hours in order to check her reactions. You may ask her where she is, what day it is or familiar names.

When should I worry during the next few days?

Take the child to the paediatrician or the hospital immediately if during the next days after the hit:

  • The child has unusual behavior or seems confused
  • The child has a severe headache
  • The child has frequent vomiting
  • Blood or fluid is flowing from the nose or the ear
  • The child has a seizure
  • The child doesn’t wake up easily
  • The child has anything else that you find worrying

Stelios Papaventsis Paediatrician MRCPCH DCH IBCLC 2010

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