Head injury is a broad term representing a wide range of injuries to the skull, brain, underlying tissues, and blood vessels. An injury can be mild, with a bump or bruise on the head or a serious one, which causes severe brain injury, concussion, or bleeding. Although often invisible, serious head injuries in children can be life-threatening, causing permanent neurological impairments (1).
Read on to learn more about the types, symptoms, diagnosis, complications, and management of head injuries in children.
Types Of Head Injuries In Children
A head injury can be of an open type or closed type. An open head injury occurs when an object hits the head and penetrates the skull and brain. A closed head injury occurs when an object hits the scalp but does not damage the skull (2).
Head injuries can be of various types depending on the extent and severity of tissue damage. Below are the common types of head injuries (3).
- Scalp injury: These are common injuries that happen while a child is growing up. The damage to the scalp can be in the form of a cut, scrape, bruise, or swelling.
- Concussion: Concussion is a type of head injury where the brain moves or jolts within the skull due to a sudden impact on the head. The injuries are often not life-threatening but temporarily affect the functioning of the brain until it heals.
- Skull fracture: It is a severe type of head injury since the skull bone breaks or fractures. There are four types of skull fractures, linear, depressed, diastatic, and basilar, based on the damaged part of the skull.
- Contusion: It is a type of serious brain injury where the brain tissue is bruised. It occurs due to a hard blow to the head, leading to bleeding and swelling in the brain.
Causes Of Head Injuries In Children
Head injuries occur due to an impact on the head. Below are the common events that may cause an impact on a child’s head (1).
- Falls: Falling from a height, tripping over, and slipping are the most common causes of head injuries in children.
- Sports-related accidents: Sports-related head injuries may occur due to getting hit by a ball, bumping into other children, or falling while cycling or skating.
- Motor vehicle accidents: These injuries occur due to traffic accidents and include accidents due to pedestrians struck by a vehicle.
- Child abuse or violence: According to a CDC study, child assault accounted for about 42% of traumatic brain injury-related deaths in children between 2006 and 2010 in the US (4). Head injuries due to shaking are common among infants and toddlers.
Symptoms Of Head Injuries In Children
The symptoms of head injury in children could vary depending on the severity of the injury.
- A swelling or bump on the head
- Bruise in the forehead or head extremities
- Perplexed behavior
- Difficulty thinking
- Frequent headaches
- Nausea and vomiting
- Feeling tired and lack of energy
- Weak or clumsy body movements
- Vision and taste changes
- Mood and behavioral changes
- Memory problems
- Anxiety and nervousness
- Sleep problems (sleeping more or less than usual, or trouble sleeping)
Moderate to severe head injury may cause the following symptoms.
- Bouts of vomiting or nausea
- Excessive sweating
- Large wound with visible underlying tissue
- Long-lasting headaches
- Pale-looking skin and weak eyes
- Weakness in one side of the body
- Blood or fluid discharge from ears or nose
- Short-term memory loss
- Loss of thinking
- Loss of consciousness
When To See A Doctor
The symptoms of a head injury may resemble those of other conditions. Also, it may not always be clear whether the symptoms are due to a minor or major head injury. Therefore, if your child sustained a head injury or you suspect a head injury due to an accident or event, take your child to a doctor.
- Head injury after a motor vehicle crash or after a fall from a height more than one meter.
- Severe headaches, bleeding, or seizures develop after a head injury.
- Constant vomiting or difficulty breathing after a head injury.
- Your child seems to lose memory or consciousness.
- You notice behavioral, speech, and sleep-related changes.
Diagnosis Of Head Injuries In Children
The diagnosis of head injuries in children is made by a healthcare professional. Physical examination is done to check the extent of tissue damage after a head injury. The doctor may test the child’s vision, hearing ability, balance, and reflexes.
Complications Of Head Injuries In Children
A head injury may lead to complications immediately after an injury or later, depending on the area of brain damage and the severity of the injury. The possible complications that may arise as a result of a head injury in children are (9) (10):
- Personality and behavioral changes
- Inability to process information
- Changes in hearing, vision, and taste
- Motor and intellectual disabilities
- Sudden seizures (post-traumatic epilepsy)
- Defects in the skull
- Fluid build-up in the brain cavities (leading to a condition called hydrocephalus)
- Leakage of cerebrospinal fluid (CSF)
- Cranial or vascular nerve damage, leading to infections
- Intracranial hemorrhage (ICH) (caused by bleeding inside the skull)
Treatment For Head Injuries In Children
Treatment options are chosen based on the child’s age and the head injury’s severity. Mild head injuries may require wound dressing at an outpatient clinic. However, severe head injuries may require hospitalization with surgical interventions for wound repair and prevention of complications. Medications may also be prescribed to ease swelling and help in the healing process.
- Apply an ice pack to reduce swelling and discomfort.
- If your child is bleeding, control the bleeding by pressing a clean cloth on the wound. Don’t touch the wound if it is open. Instead, cover it with a bandage and visit a doctor. Severe wounds may require stitches.
- Minor scalp cuts or wounds can be treated with an adhesive bandage and topical application of ointments.
- Encourage the child to take ample amounts of rest to help them recover quickly. This is useful in cases of concussions and surgical treatments for a head injury.
- If your child gets unconscious, they may have a serious underlying injury. Try to revive them with CPR. If they don’t respond, contact your doctor immediately.
While you may treat minor head injuries at home with minimal care or treatments, you need to monitor your child closely. Seek medical care immediately if you feel that your child’s symptoms worsen or their condition is severe.
Prevention Of Head Injuries In Children
It is hard to keep children injury-proof at all times. But you may consider taking certain preventive measures to reduce the risk of head injuries in your child (13).
- Childproof your house to avoid house-related accidents, such as falls from furniture or injuries due to a piece of furniture falling on the child.
- Install window guards and set up safety gates at the top and the bottom of the stairs.
- Make sure your child’s beds are firm to prevent falls.
- While outdoors, your child must always follow road safety rules.
- Check if the outdoor play surfaces are soft and are safe for your child’s playing.
- Your child should wear a well-fitted helmet while riding a bicycle or skating.
- Ensure your child wears properly-fitted protective gear while playing sports that make the player susceptible to head injuries.
- Your child must follow car safety rules by wearing seat belts all the time while traveling in a car or other motor vehicle.
- You must make sure to refrain from driving with your child when tired or when you have consumed alcohol or illegal drugs to prevent road accidents.
- If your child had a head injury in the past, wait until their doctor gives them the go-ahead to return to playing.
Frequently Asked Questions
1. How long can a child sleep after a head injury?
Your child should get plenty of rest and sleep, especially in the first 24 to 48 hours following a head injury. Avoid waking the child except for meals. If you have any difficulty waking your child, call for help immediately (6).
2. How long should I watch a child after a head injury?
You need to check if they can sleep and normally respond for the first four hours. You can then keep checking your child every two hours to monitor their condition and responses. Be quick to call the doctor if you are worried about any signs of complications in your child (14) (15).
Children are often prone to head injuries due to their active lifestyle and inquisitive nature. Most head injuries in children tend to be mild, with no lasting effects. However, severe head injuries may occur, especially after a fall or motor vehicle accident. Do not hesitate to speak to a doctor after your child’s head injury. It could help determine any underlying tissue damage not visible externally and avoid any long-term complications.
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- Kimberly S. Quayle, et al.; Diagnostic Testing for Acute Head Injury in Children: When Are Head Computed Tomography and Skull Radiographs Indicated?
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