internal 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 cause injury to the scalp only. While these can be scary-looking,
they usually aren't dangerous. An internal head injury
could be more serious because it may cause bleeding or bruising of the brain.
External (Scalp) Injuries
The scalp is rich with blood vessels, so even a minor cut there can bleed a lot.
Sometimes the scalp’s veins leak fluid or blood into (and under) the scalp.
This appears as a "goose egg" or swelling on the head. It may take days or even a
week to disappear.
What to look for and what to do:
Call the doctor if your child is an infant; has lost consciousness, even briefly;
or if a child of any age has any of these symptoms:
won't stop crying
complains of head and neck pain (younger or nonverbal children may be more fussy)
vomits several times
won't awaken easily
becomes hard to console
isn't walking or talking normally
If your child is not an infant, has not 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 every
3 to 4 hours. If you use ice, always wrap it in a washcloth or sock; ice applied directly
to bare skin can injure it.
Watch your child carefully for the next 24 hours. If you notice any of the
signs of internal injury, call your doctor right away.
If the incident happens close to bedtime or naptime and your child falls asleep
soon afterward, check in a few times while he or she sleeps.
If color and breathing are normal, and you don't sense a problem,
let your child sleep (unless the doctor has advised otherwise). There's no
need to keep a child awake after a head injury.
Trust your instincts. If you aren't comfortable with your child's appearance,
partly awaken your child by sitting him or her up. Your child should fuss a bit and
attempt to resettle. If he or she still seems very drowsy, try to awaken your child
fully. If your child can't be awakened or shows any signs of internal injury, call
the doctor or 911 for an ambulance.
Cerebrospinal fluid (CSF) is a clear fluid that cushions the brain from damage.
But a severe blow to the head can still knock the brain into the side of the
skull or tear blood vessels.
Some internal head injuries can be serious and possibly life-threatening. These
include a broken skull bone, torn blood vessels, or damage to the brain itself.
It can be hard to know how serious a head injury is, so it's always wise to
call your doctor.
Symptoms and What to Do
Call 911 if your child shows any of these symptoms after a head injury:
unconsciousness for more than a few seconds
obvious serious wound
bleeding or clear fluid from the nose, ear, or mouth
Do not try to move your child in case there is a neck
or spine injury.
Call for help.
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 your child is conscious:
Do your best to keep your child calm and still.
If there's bleeding, apply a clean or sterile bandage.
Do not attempt to cleanse the wound, which can make bleeding
worse and/or cause serious complications if the skull is fractured.
Do not apply direct pressure to the wound if you suspect the
skull is fractured.
Do not remove any object that's stuck in the wound.
the temporary loss of normal brain function due to an injury — are also
a type of internal head injury. Repeated concussions can permanently damage the brain.
In many cases, a concussion is mild and won't cause long-term damage. Kids who
get a concussion usually recover within a week or two without lasting health problems
by following certain precautions and taking a break from sports and other activities
that make symptoms worse.
is one of the most common causes of concussions. To help protect your kids, make
sure that they wear the proper protective gear, and don't let them 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
"seeing stars" and feeling dazed, dizzy, or lightheaded
memory loss, such as trouble remembering what happened right before and after
blurred vision and sensitivity to light
slurred speech or saying things that don't make sense
problems 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
If you suspect a concussion, call your doctor right away.
Preventing Head Injuries
It's impossible to prevent kids from ever being injured, but there are ways to
help prevent head blows.