Head injuries fall into two categories:
(usually scalp) injuries
head injuries, which may involve the skull, the blood vessels
within the skull, or the brain
Fortunately, most childhood falls or blows to the head result in
injury to the scalp only, which is usually more frightening than
threatening. An internal head injury could have more serious
implications because the skull serves as the protective helmet for
External (Scalp) Injury
The scalp is rich with blood vessels, so even a minor cut there
can bleed profusely. The "goose egg" or swelling that may
appear after a head blow is the result of the scalp's veins
leaking fluid or blood into (and under) the scalp. It may take days
or even weeks to disappear.
What to look for and what to do:
- Call the doctor if your child is an infant; has lost
consciousness, even momentarily; or if a child of any age has any
of these symptoms:
- won't stop crying
- complains of head and neck pain
- becomes difficult to console
- isn't walking normally
- If your child is
an infant, has
lost consciousness, and is alert and behaving normally after the
fall or blow:
- Apply an ice pack or instant cold pack to the injured area
for 20 minutes. If you use ice, always wrap it in a washcloth
or sock; ice applied directly to bare skin can cause
- Observe your child carefully for the next 24 hours. If you
notice any of the signs of internal injury (see below),
call your doctor immediately.
- If the incident has occurred close to bedtime or naptime
and your child falls asleep soon afterward, check in every few
hours to look for twitching limbs or disturbances in color or
- If color and breathing are
, and you observe or sense no other abnormalities, let your child
sleep (unless the doctor has advised otherwise). There's
to keep a child awake after a head injury.
- If color and/or breathing are
, or if you aren't comfortable with your child's
appearance (trust your instincts), arouse your child partially by
sitting him or her up. Your child should fuss a bit and attempt
to resettle. If he or she doesn't protest, try to awaken your
child fully. If your child can't be awakened or shows any
signs of internal injury (see below), call the doctor or an
Suspected Internal Injury
The brain is cushioned by cerebrospinal fluid, but a severe blow
to the head may knock the brain into the side of the skull or tear
blood vessels. Any internal head injury - fractured skull, torn
blood vessels, or damage to the brain itself - can be serious and
possibly life threatening.
Different levels of injury require different levels of concern.
It can be difficult to determine the level of injury, so it's
always wise to discuss a head injury with your doctor. A clear
indicator of a more serious injury is when a child loses
consciousness or has signs of confusion.
What to Look for and What to Do
Call an ambulance if your child shows any of these symptoms:
- abnormal breathing
- obvious serious wound or
- bleeding or clear fluid from the nose, ear, or mouth
- disturbance of speech or vision
- pupils of unequal size
- weakness or paralysis
- neck pain or stiffness
more than two to three times
- loss of bladder or bowel control
If your child is unconscious:
try to move your child in case there is a neck or spine
- Call for help.
- If you've been trained in
, follow the recommendations if they're appropriate.
- Turn a child who is vomiting or having a seizure onto his or
her side while trying to keep the head and neck straight. This
will help prevent choking and provide protection in case of neck
and spine injury.
- If there's swelling, apply an ice pack or cold pack.
If your child is conscious:
- Do your best to keep your child calm and still.
- If there's bleeding, apply a sterile bandage.
attempt to cleanse the wound, which may aggravate bleeding and/or
cause serious complications if the skull is fractured.
apply direct pressure to the wound if you suspect the skull is
remove any object that's stuck in the wound.
are also a type of internal head injury. A concussion is the
temporary loss of normal brain function due to an injury.
Repeated concussions can result in permanent injury to the brain.
However, it's possible to get a concussion that's mild and
just requires observation.
One of the most common reasons kids get concussions is through
, so make sure they wear appropriate protective gear and don't
continue to play if they've had a head injury.
If your child sustains an injury to the head, watch for these
signs of a possible concussion:
- "seeing stars" and feeling dazed, dizzy, or
- memory loss, such as trouble remembering what happened right
before and after the injury
- nausea or vomiting
- blurred vision and sensitivity to light
- slurred speech or saying things that don't make
- difficulty concentrating, thinking, or making decisions
- difficulty with coordination or balance (such as being unable
to catch a ball or other easy tasks)
- feeling anxious or irritable for no apparent reason
- feeling overly tired
If you suspect a concussion, call your doctor for further
Preventing Head Injuries
It's impossible to prevent kids from ever being injured, but
there are ways to help prevent head blows.
Make sure that:
- your home is
to prevent household accidents
- your kids always wear appropriate headgear and safety
, in-line skating, skateboarding, snowboarding or skiing, and
. Wearing a bike helmet, for instance, reduces the risk of
concussion by about 85%.
- kids always use a
seat belt or child safety seat
- your child takes it easy after a head injury, especially
after a concussion, and doesn't go back to rough play or
playing sports until the injury has healed. (If your child
reinjures the brain while it's still healing, it will take
even more time to completely heal. Each time a person has a
concussion, it does additional damage.)
Yamini Durani, MD
Date reviewed: May 2007
Note: All information is for educational purposes only. For specific medical advice,
diagnoses, and treatment, consult your doctor.
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