A headache can be defined as pain that is felt in the head or upper neck. The type of pain associated with a headache may be described as dull, sharp, constant, throbbing, mild or intense. Headaches are one of the most common health-related conditions and are usually caused by more than one factor.…
Head injuries in children
Head injuries in children
Head injuries are a common reason for parents and caregivers to take children to a hospital emergency department. Most head injuries are not severe; however, occasionally they may be life-threatening and/or result in long-term complications. For this reason, it is important that head injuries in children are assessed by a doctor.
In general, children are at increased risk of more serious head injuries than adults because they:
- Have thinner skull bones;
- Have immature brains that are more vulnerable to damage from an injury;
- Have a larger head-to-body-weight ratio, and;
- Are more likely to lose a large amount of blood.
Head injuries can occur in children of all ages, but they tend to occur more often in boys than in girls. Most are due to:
- Falling from a great height;
- Car accidents;
- Playing contact sports, or;
- Falling off a bicycle or other equipment.
Signs and symptoms
The signs and symptoms of a head injury vary, according to the severity of damage, but can include:
Minor head injuries
- Vomiting no more than once, immediately after the injury;
- Bruises or cuts on the head and/or face;
- No loss of consciousness, and;
- The child is alert and responsive.
Moderate head injuries
- Vomiting twice or more;
- Blurred vision;
- Memory loss;
- Loss of balance;
- A brief seizure, immediately after the injury;
- Large bruises or cuts on the head or face;
- Loss of consciousness for less than 30 seconds, and;
- The child recovers to be alert and responsive.
Severe head injuries
- Persistent vomiting;
- Arm or leg weakness;
- Unequal pupils;
- Neck pain or stiffness;
- Bleeding from the nose or ears;
- Loss of consciousness for more than 30 seconds, and;
- Drowsiness and/or a delayed response when spoken to.
Seek urgent medical attention at your nearest hospital if you suspect a severe head injury.
Concussion is when a head injury causes a temporary impairment in brain function. It can commonly occur after a minor or moderate head injury. Typical symptoms include:
- Problems with memory and concentration;
- Loss of balance or coordination;
- Nausea or vomiting;
- Ringing in the ear;
- Blurred vision, and;
- Sensitivity to light.
These symptoms gradually resolve, sometimes over a period of several weeks.
Methods for diagnosis
A head injury is usually diagnosed by taking a medical history from the child or parent/caregiver and performing a physical exam to assess the damage. Most children with a minor head injury do not require any tests, as the risk of significant injury is low. However, a period of observation is common to ensure the child remains well.
Further tests may be conducted in children with a moderate or severe head injury. A computerized tomography (CT) scan is usually the initial test to be performed. Other tests may be ordered if additional injuries are suspected.
Types of treatment
Following a suspected or observed head injury, it is important to:
- Keep the child calm and still;
- Gently apply pressure to any bleeding cuts;
- If the child is having a seizure or is vomiting, turn them on their side to prevent choking, but try to keep the head and neck in line and straight to protect the spine, and;
- Call an ambulance immediately if the child is unconscious.
- Commence cardiopulmonary resuscitation (CPR) if the child is not breathing.
Promptly seek medical attention after a head injury in children.
Treatment for a head injury is aimed at reducing the chance of permanent brain damage. Seeking urgent medical attention is important, as outcomes improve when treatment starts early.
Assessment and treatment of a head injury is best performed in a hospital. The exact treatment will depend on the types of injuries sustained.
In some cases, a minor head injury can potentially be cared for at home. However, close monitoring is required to ensure the child continues to remain well. Suggested care at home may include:
- Applying an icepack to affected areas, making sure it is wrapped in a towel or washcloth to prevent injuries from direct contact with bare skin;
- Providing pain-relief medication for a headache, such as acetaminophen or ibuprofen;
- Dressing any minor cuts, but seeking medical attention if the bleeding does not stop after 10 minutes, or the cut is large;
- Checking that a sleeping child remains well if the accident happened just before bedtime - if something seems abnormal, promptly seek medical attention, and;
- Preventing further participation in sport for the next 24 hours, particularly if the child was injured during that sporting activity.
Most children with a minor head injury will make a full recovery. If serious injuries occur, potential complications can include:
Following a concussion, some children may experience ongoing symptoms for a few months, also known as post-concussion syndrome. Symptoms may include nausea, memory problems, headache, dizziness and poor concentration.
A coma can occur when the brain is functioning at a reduced level, resulting in a prolonged loss of consciousness. It may only last a few days or weeks, but in some cases may last longer.
Head injuries can lead to permanent brain damage, particularly with severe head injuries. The location and severity of brain damage will depend on the type of head injury, the amount of time that passes before treatment is received and the presence of any other complications.
Brain damage can result in physical and/or intellectual disabilities, which may need ongoing medical treatments, lifelong nursing support, or care in a specialized nursing home.
Moderate to severe head injuries often involve wounds or bone fractures, which can provide an opportunity for bacteria to enter the body through a break in the skin. As a result, infections can occur after a head or brain injury.
Children with minor head injuries and those without any brain damage generally make a full recovery without any long-term complications. Outcomes for severe head injuries, especially if there is brain damage, depend on the severity of the brain damage and presence of any other complications.
To help prevent head injuries from occurring in children under your care, you can:
- Childproof your home to prevent household accidents;
- Ensure the use of appropriate safety headgear when riding a bike, skating, skateboarding, snowboarding, skiing or playing contact sports;
- Ensure the use of protective headwear or a specialized helmet in children who are recovering from a previous head injury, or are prone to bumping their heads;
- Avoid placing babies or toddlers on high pieces of furniture, and supervise them at all times while in a highchair or using play equipment;
- Strap your child into their stroller and high chair;
- If you have a play gym, cover the area under and around it with soft materials, and;
- Always use a seatbelt or child safety seat during car trips.
- Clinical Practice Guidelines : Head Injury Guideline.Accessed September 26 2014. http://www.rch.org.au/clinicalguide/guideline_index/Head_Injury_Guideline/.
- Head Injuries. Accessed September 26 2014. http://kidshealth.org/parent/firstaid_safe/emergencies/head_injury.html.
- Head Injuries - First Aid. Better Health Channel. Accessed September 26 2014. http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Head_injuries_first_aid.
- Head Injury. Accessed September 26 2014. http://www.adhb.govt.nz/starshipclinicalguidelines/Head%20Injury.htm.
- Head Injury (Brain Injury) Causes Symptoms Treatment - Head Injury Prognosis: Outlook and Recovery.” eMedicineHealth. Accessed September 26 2014. http://www.emedicinehealth.com/head_injury/article_em.htm.
- Head Injury in the Child - Wheeless’ Textbook of Orthopaedics. Accessed September 26 2014. http://www.wheelessonline.com/ortho/head_injury_in_the_child.
- Kids Health Info : Head Injury - General Advice. Accessed September 25 2014. http://www.rch.org.au/kidsinfo/fact_sheets/Head_injury/.
FAQ Frequently asked questions
What are the symptoms of head injuries in children?
Symptoms of a head injury may vary, depending on the age of the child and the cause and severity of the injury. Possible symptoms may include headaches, bruising, bleeding, swelling, vomiting and dizziness. In more severe injuries, the …
What causes head injury in children?
Most head injuries are the result of a sporting accident, a fall from a height, or a motor vehicle accident.
How is a head injury diagnosed?
A head injury is diagnosed with a medical history from the parent or caregiver, and a physical examination. Most mild cases of injury will not require any imaging, but a computerized tomography (CT) scan may be performed for a moderate to severe injury.
How is a head injury treated?
Treatment for a head injury will depend on the severity of the injury and symptoms. Most mild head injuries can be treated at home with observation to ensure that no more serious symptoms develop over time. If the injury is more serious, it may require …
Will a head injury clear on its own?
Most mild and moderate head injuries will resolve over time, leading to a full recovery without any complications. However, a severe head injury may require ongoing medical attention and treatment.
What can be done at home to treat a head injury?
Treatment for a head injury will depend on the severity of the damage. Assuming there are no complications, most mild head injuries can be treated with pain-relief medications, rest, and icepacks applied to the affected area. More severe …
Can head injuries be prevented?
Many head injuries can be prevented by supervising children while they are on high furniture or equipment, and by making sure any play areas at home are surrounded by soft landings. It is also important to ensure that children wear a helmet while riding a …
What is the prognosis following a head injury?
Minor head injuries with no associated brain injury generally result in a full recovery without long-term complications.
Is a head injury serious?
Although some head injuries can be serious and potentially life-threatening, most mild and moderate cases of head trauma can be effectively treated and result in a full recovery.