- History of a blow to the head
- Scalp trauma (cut, scrape, bruise, or swelling)
Head Trauma Cause
Every child sooner or later strikes his head. Falls are especially common when your child is learning to walk. Most bruises occur on the forehead. Sometimes black eyes appear 3 days later because the bruising spreads downward by gravity.
Most head trauma simply results in a scalp injury. Big lumps can occur with minor injuries because the blood supply to the scalp is so plentiful. For the same reason small cuts here can bleed profusely. Only 1-2% of injured children get a skull fracture. Usually there are no associated symptoms except for a headache at the site of impact. Your child has not had a concussion unless there is temporary unconsciousness, confusion, and amnesia. It is common for children to vomit shortly after a head injury. Up to 3 bouts of emesis is common but if your child continues to vomit or does not start vomiting until several hours after the head injury, your child needs to be seen in the office or the ER if it is after hours.
Home Care for Head Trauma
Wound Care. If there is a scrape, wash it with soap and water, and apply pressure with a clean cloth (sterile gauze if you have it) for 10 minutes to stop any bleeding. For swelling, apply ice for 20 minutes.
Rest. Encourage your child to lie down and rest until all symptoms are gone (or at least 2 hours). Your child can be allowed to sleep; you don’t have to try to keep him awake. Have him sleep nearby so you can periodically check on him. Don’t give any pain medicine. If the headache is bad enough to need pain medicine, your child probably should be checked by a physician.
Diet. Only give clear fluids (ones you can see through) until your child has gone 2 hours without vomiting. Vomiting is common after head injuries, and there is no need to have him vomit up his dinner.
Pain Medicines. Don’t give any pain medicine. If the headache is bad enough to require acetaminophen or ibuprofen, your child should be checked by a physician.
Special Precautions and Awakening. Although your child is probably fine, close observation for 48 hours after a head injury resulting in a concussion, will ensure that no serious complication is missed.
- Awaken your child twice during the night: once at your bedtime and again 4 hours later. Awakening every hour is unnecessary. Arouse him until he is walking and talking normally. Sleep in his room or have him sleep in your room for two nights. If his breathing becomes abnormal or his sleep is otherwise unusual, awaken him to be sure a coma is not developing. After two nights, return to a normal sleep routine.
CALL OUR OFFICE IMMEDIATELY if:
- The headache becomes severe.
- Vomiting occurs three or more times.
- Vision becomes blurred or double.
- Your child becomes difficult to awaken or confused.
- Walking or talking becomes difficult.
- Your child’s neurological condition worsens in any other way.