Head Injuries In Children: When To Worry About It? by Dr. Chetan Ginigeri

7 min read

Written by Dr. Chetan Ginigeri

Dr. Chetan Ginigeri

Head Injuries in Children

The children are very restless and very curious by nature. As parents, we try all possible means to keep them in control, to make them responsible and keep them safe. But, it can be difficult to keep a continuous watch on them. Sometimes, due to situations beyond our control, kids do get hurt. Most of these injuries are routine and heal on their own with a little love and first aid. In other cases though, for example, in the case of head injuries in children, parents and caregivers need to be extra vigilant post-injury since the consequences may be bad at times.

There are different types of head injuries. Some of them can heal quickly while others may need a visit to the doctor, and in some cases, further tests to ensure that everything is fine with the child. It is important for parents and caregivers to understand red flags to look out for and when to worry in case of a head injury. Read this article to know more about head injuries in children and how to take care of them and when to rush to a doctor.

In This Article

What is Head Injury?

Head injury is the name given to the group of different injuries that can occur to the various parts of the head including the scalp, the skull, and the brain, as well as the blood vessels and tissues present in the brain. A brain injury can vary from a minor bump to a serious brain injury which is also known as a traumatic brain injury.

Since children are always exploring, high on energy, and full of curiosity, falls and head injuries in children are quite common.

Types of Head Injuries

Types of Head Injuries in Children

There are four different types of brain injuries. They are

1. Concussions

A concussion is an injury that occurs due to a blow or an impact to the head. Concussion is counted among traumatic brain injuries and occurs due to jarring or shaking of the brain post-injury. Sometimes shaking of the upper body due to an injury can also cause concussion to the brain. Effects include headache, temporary loss of memory, concentration, focus, and coordination lasting for a few minutes or up to a few hours post injury.

2. Contusion

A bruise to the brain is called a concussion.  A contusion can happen due to a blow to the head and can cause bruising, swelling and bleeding in the area of the brain where the blow happens. In some cases, this type of injury can occur along with a skull fracture or clotting.

3. Skull Fracture

A skull fracture is a fracture or a broken bone that happens to the skull. Skull performs two functions- it forms a protective covering for the brain and also gives a shape to your face. Fractures can be dangerous because bits of broken bone can cut into the brain and cause bleeding and injuries.

4. Intracranial Haematoma

Intracranial haematoma is a clot that forms in the brain and under the skull. This can happen due to an accident or a fall or sometimes even a ruptured blood vessel.

Signs And Symptoms of Head Injuries

Some of the common signs and symptoms of head injuries in children include

  • Headaches/ Pain in the area of injury
  • Cut or wound in the head area
  • Bump or swelling in the area of the head where the child is hurt
  • Wound or cut on the head or the scalp
  • Confusion
  • Irritability
  • Inability to see light
  • Blurred vision
  • Irritability to sounds and noises
  • Temporary loss of balance
  • Dizziness
  • Vomitings – once or twice

Serious symptoms that may need immediate medical attention include

  • Loss of consciousness
  • Difficulty in staying awake
  • Repeated convulsions
  • Severe headaches
  • Repeated nausea and vomitings
  • Pupils of uneven sizes in both eyes
  • Difficulty in speaking
  • Difficulty in walking
  • Inability to recollect events

What To Watch For After Head Injuries?

All kids keep falling while they are playing, and head injury is something that almost all kids experience. As a parent, the cause of worry should be if the child falls on the head, develops a goose egg that isn’t disappearing, and is spongy and wet, even after applying cold packs. In a condition where the child gets hit on the head, cries for a little while, but resumes playing or has a goose egg that might be hard or soft but disappears in a few minutes, the parents need not worry at all.

What To Do If You Suspect Your Child Has Suffered A Concussion?

Concussion Symptoms in Children

Head injury is very common, but its magnitudes vary. A simple head injury shows no strange signs. The child may get a bruise on their head but will be fine in some time.

However, a concussion is to a brain injury due to which the brain cannot function in a normal state for some time. This occurs due to various reasons such as head trauma or a head injury due to a fall, a hit on the head by a strong ball or an accident etc. Such injuries can be threatening for the child as they cannot express their feelings, so parents must keep a watch on them. Symptoms do not start right after the injury and can start appearing after a few hours or after the lapse of a few days.

Some symptoms of concussion in children include

  • Weepiness when trying to move the head
  • Irritation
  • Disturbed sleeping schedules
  • Head bruises
  • Nausea

Always seek medical help if you find your child having the above symptoms.  The recovery phase from this can even take months or even years depending on how acute the injury is. If the child has had a concussion, let them rest amply. Keep them away from gadgets as screen time can cause overstimulation, and it is significant to avoid having another head injury as the consistent occurrence of concussions can lead to brain damage.

Sleeping With A Paediatric Head Injury

A head injury can be mild, as well as severe. A mild head injury with mild symptoms such as headache, nausea, and dizziness are not a source of worry. A child may cry a lot after getting injured and may fall asleep due to the stress. In such conditions, you can allow the child to sleep in a position where they feel comfortable.

If you suspect a severe head injury and your child is displaying unusual symptoms or the ones listed above, it is vital to rush your child to the doctor immediately.

When Should You Seek Immediate Medical Attention?

When Should You Seek Immediate Medical Attention

Kids, even though they are quite playful but have their own ways to let you know that something is not right, and they are not feeling good. Being parents, we just need to understand their indications and act. It is often seen that when kids are too sleepy, they either rub their eyes, become clingy or stubborn, or cry unnecessarily. If your kid is vomiting and losing appetite, feeling drowsy, getting unconscious, with low energy, suffering from a nerve-wracking headache, your child needs immediate care.

When Should You Call Your Paediatrician?

Your child might not show any signs after getting hurt on their head. Yet they do not seem to be themselves and look dull. This is the biggest indication that you have to rush your little one to a pediatric emergency. The pediatrician will investigate the situation and then decide what would be the best action that can be taken.

Given below is a small table that depicts the situation when to worry and when to take medical help when the child suffers from a head injury.

Take Instant Medical Attention Under These Symptoms Do Not Worry Much If These Signs Prevail
The child gets unconscious or drowsy. The child is shocked and scared but conscious.
There is blurry vision, eyes size is changing, and the child is not able to move the eyes in coordination. There is no problem with the eyes or eyesight.
The child is feeling weak and not ready to move, and if trying to walk, is finding it tough. Resumes playing after a while and do not feel weak and can do all activities normally.
Acute head pain Very slight head pain on persistent questioning.
He has vomited more than twice and still feeling the same. Vomited once or 3-4 days after the injury has taken place.
Blood or fluid from nose and ears. nose She is crying with fluid or mucus from the nose, which stops once crying stops.
Persistent bleeding from the scalp. A small wound that bleeds but stops after around 10 minutes.
The child gets irritated, impatient, and keeps crying for almost an hour. The child gets distracted and is composed, yet slightly clingy like when he has a cold and fever. This is fine because kids do seek attention after they get hurt and want to be clingy.
The child does not seem to be himself but cannot figure out what is happening. The child wishes to play, talk, become naughty and resumes his original self.

Preventing Head Injuries In Children

Preventing Head Injuries In Children

Kids are playful and adventurous. It is normal for them to fall and get hurt. Here are a few precautions you can take to prevent your child from getting head injuries.

1. Teach your little one the importance of head safety and the dangers of head injuries. Let them know why they should stay cautious while playing or participating in physical activities.

2. Teach them to put on helmets while cycling, to ride, etc. Explain that headgear will keep them safe in the event of a fall or an accident and prevent head injuries.

3. For smaller babies, it is important to babyproof all sharp edges and corners in the home. Supervise them especially when they are seated in high chairs and similar furniture. Never leave small children unsupervised during their playtime.

Head injuries in children are mostly routine injuries that heal quickly. At times though, these injuries can be serious. For this reason, parents must train children on the importance of staying safe when playing. Teach your children safety measures such as wearing helmets when riding a cycle or staying safe when playing on terraces and play areas.

Dr. Chetan Ginigeri,MBBS(JIPMER), MD (PGIMER), Fellowship PICU (Kings College London)
Head of Dept – Paediatric & Neonatal services, Aster CMI Hospital
17 years of experience

Dr Chetan Ginigeri is an experienced Pediatric Intensivist with national and international training. With 15 years of experience, he is one among very few Intensivists in India trained to take care of children who need/had organ transplants. He has been responsible for coordinating the Pediatric Organ Transplant program.Read more.

Responses (1)

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Sanjeev c

Nov 04, 2020

Interesting and insightful

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