Pediatrics Common Questions, Quick Answers

Head Injuries

Donna D'Alessandro, M.D.
Lindsay Huth, B.A.
Peer Review Status: Internally Reviewed
Creation Date: October 2001
Last Revision Date: April 2002

Common Questions, Quick Answers

• What are head injuries?
• What causes head injuries?
• What are the symptoms of a head injury?
• How are head injuries treated?
• How can head injuries be prevented?
• When should I call the doctor?

What are head injuries?

• Head injuries can be either external injuries or internal injuries.
• External injuries are usually to the scalp.
• Internal injuries may be to the skull, to blood vessels within the skull, or to the brain.
• Internal injuries are generally more serious than external injuries.

What causes head injuries?

• Children can get injuries from falling and hitting their head or from bumping their head into something.
• Children can get head injuries while playing sports.
• Other accidents (such as car accidents) can cause head injuries.

What are the symptoms of a head injury?

External Injuries

• When children fall, they usually get external head injuries. These injuries can frighten both the parent and the child but they are not usually serious.
• The scalp has many blood vessels. Even small cuts to the head may bleed a lot.
• If your child bumps her head, it may swell in one place.
• This bump on the head, or "goose egg," may take days or weeks to go away.
• A bigger bump does not always mean a more serious injury. Big bumps can be minor and small bumps can be serious.

Internal Injuries

• Older children are more likely to be involved in activities that could result in an internal head injury
• Call an ambulance if your child has signs of an internal injury:
• Unconsciousness, child is not alert or awake.
• Breathing is not normal.
• Serious wound.
• Serious fracture (damage to bones or skull).
• Bleeding from eyes, nose, ears, or mouth.
• Speech isn't normal.
• Changes in vision or pupils are not the same size.
• Feeling weak, dizzy, or not able to move.
• Neck hurts or is stiff.
• Seizure.
• Vomiting, wetting pants, or losing bowel control.

How are head injuries treated?
External injuries are usually not serious and can probably be treated at home. If there are signs of an internal injury (see list above) immediately call the doctor or an ambulance. While you wait for help, do as follows:

External Injuries

• Put an ice pack or instant cold pack to the injured area for 10-15 minutes. Always wrap the ice in a washcloth or sock. Putting ice directly on bare skin can cause frostbite.
• Watch the child closely for 24 hours. If she shows sign of an internal injury (see list above), call the doctor at once.
• If your child is upset, she may vomit right after the injury. Vomiting once is OK. If she vomits more than once, call your doctor.
• If your child takes a nap or falls asleep shortly after being injured, check her every few minutes. Watch for changes in breathing, changes in the color of her face, or twitching arms and legs. Let the child sleep if all are normal.
• If child does not appear normal, wake her up a little. Have her sit up. She should fuss a bit and want to go back to sleep.
• If your child does not fuss or does not respond, wake her up fully. If you can't wake her up, call your doctor or an ambulance at once.

Internal Injuries
CALL YOUR DOCTOR OR AN AMBULANCE IMMEDIATELY.

If your child is unconscious….

• Do not move the child. Moving her could cause more injury. Only move the child if she is in not in a safe place.
• If there is possibility of a neck or back injury, keep her head still. Put your hands on the sides of her head to hold it in place.
• If she vomits, tip the whole body to the side, keeping the head in line with the body.
• If she is not breathing, give her mouth-to-mouth resuscitation.

If your child is conscious…

• Keep her calm and still. Do not move her if there is possibility of a neck injury. In this case, put your hands on the sides of her head to hold it in place.
• If she vomits, tip the whole body to the side, keeping the head in line with the body.
• If she has a seizure, keep her mouth clear.
• Apply some pressure to the wound if you think the skull could be fractured. Do not push too hard.
• If there is swelling, press an ice pack or cold pack against her head with firm pressure.
• If there is bleeding, put a clean bandage on the head.
• Do not clean the wound or remove an object that is in the wound. This could cause more bleeding.

How can head injuries be prevented?

• Throughout the day, children get minor injuries even if you are careful.
• Make your child's playing areas as safe as you can, but know that she may still get minor injuries.

When should I call the doctor?

• Call the doctor if your infant has a head injury or if your child is under age 2.
• Call the doctor if you think your child has an internal head injury.
• Call the doctor immediately if your child loses consciousness, even for a very short time.
• Call the doctor if the person with the head injury was using drugs or alcohol.
• Call the doctor if you suspect the child has been abused.

Quick Answers

• Head injuries can be either external injuries or internal injuries.
• Children can get head injuries from falling, hitting their head, or playing sports.
• Your child may get a bump on her head if she falls. Bumps are not usually serious. If you think your child has an internal head injury, call an ambulance.
• Minor head injuries can be treated at home. Serious injuries need immediate medical attention.
• Throughout the day, children get minor injuries even if you are careful.
• Call the doctor if your think your child has an internal head injury.

References

• The Children's Hospital of Philadelphia. Superficial Injuries to the Face and Head. 1996-2001 (cited 2001 September 6). Available from: URL: http://WWW.CHOP.EDU/cgi-bin/consumer/your_child/condition_section_index.jsp?id==8408&printable=1
• Dowshen, S M.D. Head Injuries. KidsHealth. 1998 April (cited 2001 September 6). Available from: URL: http://www.kidshealth.org/PageManager.jsp?dn=Kidshealth&lic=1&ps=107&cat_id=article_set=21651
• NASD. First Aid for Head Injuries. University of Maine: Cooperative Extension. (cited 2001 September 6). Available from: URL: http://www.cdc.gov/niosh/nasd/doc3/me97008.html

See related Patient Topics Brain and Nervous System, Head and Brain Injuries or Injuries and Wounds.

See related Provider Topics Brain and Nervous System, Head and Brain Injuries or Injuries and Wounds.

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