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HEAD INJURIES IN CHILDREN

 

Young children often get knocks on the head. These are seldom serious but parents need to be able to assess the severity of the injury and act accordingly.

 

Most children recover quickly from what is usually a minor bump that causes a few tears but does not need medical attention. However, you should check for signs of concussion and keep a careful eye on your child for several days.

 

If your child has had a head injury that led to him losing consciousness, he must not play any contact sport for three weeks.

 

Types of head injury

 

Head injuries range in severity from a minor cut to, at the other end of the scale, damage to the brain:

 

Bruising/swelling to the scalp: this will appear within minutes of a blow to the head.

 

Scalp wound: even a tiny scratch can bleed profusely because the scalp is well supplied with blood vessels. Some may need stitching.

 

Concussion: a blow to the head can 'shake' the brain, causing symptoms such as temporary loss of consciousness, nausea, dizziness, loss of memory and headache.

 

Fractured skull: a fall from a height or a traffic accident may result in a fracture to the skull.

 

Penetrating injury to the brain: occasionally, a splinter of bone from a fractured skull, or a sharp object can pierce the brain tissue.

 

Even a minor cut can bleed for a long time. Pressure should be applied and a bandage wrapped fairly tightly round your child's head.

 

Danger signs

 

If any of the following symptoms develop after a head injury, call for an ambulance:

 

• Loss of consciousness, however brief
• Visible severe wound or an abnormal dent in the scalp
• Vomiting
• Convulsions
• Dazed appearance, drowsiness
• No response when spoken to or touched.
• Clear fluid leaking from ear or nose
• Blood in the white of the eye 

When to seek medical help

 

Answering these questions should enable you to make the decision about whether to seek medical help. If in doubt, always call a doctor.

 

Is you’re child conscious? Feel the scalp for bumps and look for cuts, bruises or dents.

 

How distress is he? Persistent crying, despite of being comforted, will mean he still in distress.

 

How He is behaving? Unusual behavior may indicate concussion.  A baby may be floppy; a toddler irritable.

 

What it he telling you? An older child may be able to tell you that he is not feeling well sick or dizzy, or tell you that he is in pain.

 

If you child continues to scream for a long time after a fall or bump seek medical Advice.

 

Delayed reaction

 

Some head injuries that initially appear to be minor can develop into serious cases. It is important to monitor your child's wellbeing closely in the days following an injury.

 

• In infants, the bones of the skull are not fused together, allowing brain tissue to swell without causing specific symptoms. 
• In older children, the skull bones have fused together so that if the brain swells due to damage, signs of increased pressure inside the skull will gradually appear. 
• Signs of increased pressure within the skull, which may lead to unconsciousness, include headache, unequally sized pupils, weakness in one side of the body or face, fever and drowsiness.  

First aid at home

 

If your child seems to have no ill effects and the head injury is minor, basic first-aid measures are usually very effective.

 

Bruising and swelling: you can use an icepack to reduce swelling. A bag of frozen peas is excellent for this, but remember to wrap it in a tea-towel first so that it doesn't damage the skin.

 

Bleeding: the priority with a scalp wound is to stop the bleeding. Sit or lie the child down and place a clean dressing or kitchen paper over the wound (a clean handkerchief will do if you don't have a first-aid kit) and gently press for a few minutes. Once the bleeding has stopped, secure the dressing in place, using tape or a light bandage.

 

Serious injury: if the injury is not minor and you are concerned about your child's condition, there are measures you can take while waiting for the ambulance. Keep the child still in a quiet room. If he is unconscious, check his breathing and pulse regularly and make sure that if he is sick, there is no vomit blocking his airway. Keep your child lying on his side, either on your lap or in your arms, to help keep his airway clear.

 

NOTE: you may want to apply a herbal remedy, such as arnica for swelling and calendula for cuts.

 

Hospital treatment

 

Once in the hospital, treatment very much depends on the severity of the injury, but a few basic principles will be followed.

 

A detailed neurological assessment of a child's condition helps to decide the extent of the injury, including the level of consciousness and symptoms that need monitoring. The head injury is examined, cleaned, stitched if necessary, and covered with a clean dressing.

Skull X-rays may be taken to check for a fracture.

If there is any concern, an overnight stay in hospital will probably be recommended in order to monitor your child's condition. 

More serious head injuries may involve intensive care and possibly even surgery. 

CT-scanning of the brain is sometimes carried out to check for signs of damage ­whether temporary or permanent. 

A skull fracture can occur if there is a serious blow to the head. An X-ray may be taken as part of the overall assessment.

 

Preventing Head injuries

 

Although the occasional bump and bruise are all part of growing up and learning about the hazards in life, there are several steps you can take to prevent head injuries occurring:

 

• Think about where the 'toddler-level' sharp corners are in your house and fit protective safety guards. 
• Fit all windows with safety catches and use window bars if appropriate. 
• Install stair gates. 
• Teach your child road safety from an early age.

For  More  Information:  Please  consult  your  physician  on  your  next  visit.