Head Injuries in Children

Head injuries are a common phenomenon in children. Fortunately, most head injuries are minor and only require observation over the next 24 hours, while some are quite severe and require immediate medical attention. In children who have an accident, it is head injury that usually causes the most severe sequelae. The most common reasons for head injury in children are (in order of frequency) falls, accidents when the child is the bike rider, and motor vehicle/bicycle accidents when the child is a pedestrian.

There are a number of symptoms that can appear due to head injury: loss of consciousness, confusion, amnesia, dizziness, recurrent vomiting, severe head ache, sleepiness, seizures, and restlessness. It is known that any bruise on the head after head injury, particularly in children under 2 years of age, can be a sign of internal brain injury. It should be noted that something which may look like a mild head injury, can actually be something very severe, especially in young children.

“Concussion” is a term frequently used after head injury associated with a short loss of consciousness (less than one minute), confusion or drowsiness. Occasionally it can be associated with pallor or vomiting. The significance of a concussion is that the head received a significant blow, but that there is no bleeding in the brain or other specific long term damage to the brain. In most cases, the symptoms of a concussion pass after a few hours.

Obviously, a severe head blow can cause irreversible brain injury. It’s known that a bad head injury in a baby or young child can cause brain damage that will impact on the child’s functioning in the future. This is because the nervous system was in the process of developing when it was damaged. Occasionally, a child who has a head injury, even if it is not severe, can suffer from headache, behavioral problems, and concentration difficulty for an extended period after the blow.

When should one come the doctor after a head injury?

1.If any of the above symptoms are present.
2.If there was a fall from above 1.5 meters or higher.
3.If the blow to head is considered to be severe.
4.Any head injury under one year of age, even if there is no signs or symptoms of injury.

Under most circumstances, the physical exam done by the physician can determine that no permanent brain injury is present, and can send the child home with instructions on when to come. Occasionally, a child may need to be sent to the Emergency Room in order to undergo a more thorough evaluation including a head CT.

Prevention of head injuries is possible and doable but it does demand some parental energies. Do not leave a baby unattended on a changing table or bed for even a second. Children should always have adult supervision. Parents should be meticulous about safety belts and car seats. And children must be taught rules of traffic safety especially about crossing the street. (Children under 10 years of age should not be crossing the street by themselves and certainly not be crossing children younger than themselves!). Be meticulous about helmet use while riding the bike. These are some of the elements that will help in the prevention of head injury in children.