Head Injuries in Children – Warning Signs and First Aid by Dr. Chetan Ginigeri

The extent of the injury determines if the injury falls under brain injury or traumatic brain injury (TBI). Children who suffer a head injury are at greater risk of facing disabilities. In some extreme cases, such injuries can be fatal, too.

Head Injury Warning Signs in Children

However, serious you might think the injury is, the first and most important step is to relax and stay calm. Unless it is a really major blow, your child is most certainly going to be safe. That said, it is important to take your child to the doctor if your child is:

• Unconscious or unresponsive, even for a few seconds.
• Bleeding from the nose or ears.
• Vomiting more than twice after the fall.
• Complaining of a headache that does not reduce with time.
• Appearing sluggish, confused, and disoriented.
• Crying inconsolably, or is being fussy without any apparent reason.
• You can see that the wound is obviously serious.

While every fall doesn’t warrant a doctor visit, always trust your instincts. If you think that your child is not his/her usual self after a head injury, then do not wait for any signs. Take him/her to the doctor. It cannot do any harm, and there is a chance it might actually mitigate potential harm.

Types of Head Injuries

Now, let us take a step back and understand head injuries better. There are two types of injuries that can happen – external and internal.

1. External Head Injuries

Just like any other part of the body, the skin on your child’s head (scalp) covers a large number of blood vessels. During any minor fall, only the scalp gets injuries. Because of the abundance of blood vessels here, even a small cut can mean a lot of blood – this looks scary, but thankfully it is more superficial than internal injuries.

If there is no cut, then there could be blood and fluid accumulation under the skin. This is what we call head bump. It is painful, but not very threatening. As is with any aspect with your children, you need to trust your instincts and make the best call.

If you do not suspect anything unusual with your child’s behavior, breathing, walking, and talking, there is apparently not any reason to panic and worry. You can let your child sleep unless the doctor has advised otherwise.

2. Internal Head Injuries

Before you suspect an internal injury, please understand that our body anatomy is such that the brain is very well protected from damage. Our brains are encased within a hard skull and a cushiony Cerebrospinal fluid (CSF). However, if the blow to the head was very strong, it can lead to a fracture in the skull, tear blood vessels in the brain or move the brain causing nerve damage.

This is as dangerous as it sounds and can be life-threatening. This is why your child’s doctor might want to do a CAT scan to rule out internal bleeding in case of major head blows. In case you are feeling that the child is showing some signs of internal injury, it would be wise to consult a doctor.

[Read : Preventing Injuries From Falling, Climbing, And Grabbing]

How Are Head Injuries Diagnosed?

During an assessment of head injuries, doctors ask questions about how they occurred and thoroughly examine the child’s head. The doctor will also check the nerve functioning. Medical tests are usually not necessary for children who have suffered a mild head injury like a bump.

Depending on the child’s symptoms and the severity of the injury, he or she may need one or more of the following tests:

1. X-Ray

After a traumatic head injury, the doctor may prescribe a routine X-ray. X-rays of the skull can help doctors to examine the bones of the skull, particularly those in the face, the nose, and the sinuses. By using an X-ray, the doctor can determine the severity of the head injury to the child.

2. Computerized Tomography (CT) Scans

Typically, this test is done as soon as a child with suspected traumatic brain injury arrives at an emergency room. During a CT scan, X-rays help obtain a detailed picture of the brain. CT scans enable doctors to quickly detect fractures in the skull and to look for evidence of bruised brain tissue (contusions), bleeding in the brain (hematoma), brain tissue swelling, and blood clots (hematomas).

3. Magnetic Resonance Imaging (MRI)

MRIs create detailed images of the brain by using radio waves and magnets. Typically, this test is done after the child’s condition has stabilized or no improvement in symptoms has been observed.

4. Intracranial Pressure Monitor

During a traumatic brain injury, swelling inside the skull can increase pressure inside the brain, leading to further brain damage. Doctors use intracranial pressure monitors to assess the pressure inside the brain.

What is a Concussion?

Brain injuries can lead to concussion. The degree of concussion usually depends on the speed with which the head got hit, the age and size of the kid and the surface on which the head was hit. Most mild concussions heal within a week or two.

But during this period the child should avoid further head trauma and parents must closely monitor the child for any abnormal behavior or symptoms. If the concussion is serious, then the doctor will suggest a course of action depending on your child’s symptoms and condition.

First Aid For Head Injuries in Children

Irrespective of whether you have to take your child to the hospital or not, there are a few things you need to do at home:

• If your child is unconscious, take utmost care not to move the head and neck when transferring them to the vehicle. Ideally, you should wait for an ambulance if the child is majorly hurt as there could be other injuries or broken bones, especially in the back or neck.
• If your child complains of a headache but seems otherwise fine, DO NOT give them any pain medication. It is very important to watch out how the symptoms change over time. You might miss a worsening pain if you give any medication – without doctor’s advice – to suppress it.
• If there is a head bump, use a cold compress in the area until the swelling comes down. You can pack ice in a towel (or socks) and use it to compress or use a pack of frozen peas. It is always a good idea to buy a reusable ice pack and keep it in the freezer. Never use the ice directly on the skin.
• If there is bleeding, cover the cut with it with a clean cloth or sterile bandage. Do not try to clean the wound yourself. If there is an object stuck on the wound, do not try to remove it.

[Read : Childproofing Your Home: Do It The Right Way]

Prevention of Head Injuries in Children

The main cause of head injuries is falling. This could be from furniture (like a sofa or bed) or from a standing position. The child can also hit their head on furniture corners while running. You can take the following precautions to prevent head injuries in children:

1. Childproofing Your Home

Start by cushioning the corners of the table and other furniture. There are many products available on the market for childproofing the house. But you can also use lots of cotton wool and duct tape to get the same effect.

2. Encourage Safe Sports

For example, you can encourage your child to wear a helmet, especially when cycling or playing in the park. Blows from balls. etc. have been the causes of head injuries for long.

3. Car Safety

Ensure to secure your child safely in the car with the help of a baby seat during car journeys. For older kids, you can use cars seat belts.

If you decide not to take your kid to a doctor, make sure to keep them on a watch for a day at least – to ensure new symptoms do not appear, and old symptoms do not get worse. And most importantly, do not restrict your child’s movements, fearing a fall (we can all be paranoid parents!). Let them run, jump and play – they might fall, but they will also learn how to get up and balance themselves better!

[Read : Car Safety: Tips For Parents To Keep Kids Safe]

FAQ’s

1. What is the Most Common Head Injury For Children?

Among young children, falls and accidents are the most common causes of serious head injuries. Children are most likely to experience concussions, a head injury in which the brain is shaken.

2. How Do I Know If My Child’s Head Injury is Serious?

Treating serious head injuries as soon as possible is imperative. If the child exhibits symptoms such as loss of consciousness, headaches that won’t go away, trouble walking, memory problems, seizures, weakness on one side, etc., it indicates severe brain injury.

Read Also: Top 10 Tips To Avoid Sports Injuries in Kids