Head Injury

There are 3 main types of head injuries:

Scalp injury: It's common for children to fall and hit their head, especially when learning to walk. Falls often cause a bruise on the forehead with a black eye(s) sometimes appearing 1 to 3 days later because gravity causes the bruise to spread downward. Big lumps can occur with minor injuries because there is a large blood supply to the scalp. For the same reason, even small cuts on the head may bleed a lot.

Skull fracture: Head injuries that you can't see on the outside of the head are a skull fracture or a concussion. Only 1% to 2% of children with head injuries will sustain a skull fracture. Usually, there are no other symptoms except for a headache at the site where the head was hit. Imaging is needed if a fracture is suspected.

Concussion: A concussion is a mild traumatic brain injury, or mTBI, caused by a bump, blow, or jolt to the head that can temporarily change the way the brain normally works. Concussions also occur from a blow to the body that causes the head to move rapidly back and forth. When a concussion has occurred there is a chemical imbalance inside the brain, which interferes with the nerve cells that send signals so that cognitive function has been disrupted. Concussions can occur in any sport or recreation activity. They can also happen during the course of everyday life. Imaging is not done for a suspected concussion because these injuries do not show on CT scans or MRIs.

Wound care 
If the skin is split open and might need stitches, call your healthcare provider right away. If there is a scrape, wash it off with soap and water. Then 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 have cleared (or at least 2 hours). Your child can be allowed to sleep. You do not need to try to keep your child awake continuously. Just have him sleep near by so you can periodically check on him.

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.)

Pain medicines 
Don't give any pain medicine. If the headache is bad enough to need acetaminophen (Tylenol) or ibuprofen (Advil), your child should be checked by a healthcare provider.

Concussion
First, see a licensed medical professional in order to be medically evaluated. Depending on the severity of the injury, cognitive tests may be needed to gain a better understanding of the extent of injury. Rest (both physical and mental) is usually the best treatment for a concussion, which includes a reduction of stimuli such as computers, television, noise, bright lights and physical activities. There is no quick answer to how quickly you or your child will recover but your child's doctor will give specific instructions. Symptoms typically improve within a few days or weeks. Patients can resume their normal school, work, home and sports/activity routines followed subsequent evaluations and clearance from a healthcare provider.

If your child experiences any of the following, seek immediate emergency care:

• seizure
• blood or fluid coming out of her nose or ears
• loss of consciousness
• worsening headaches
• vomiting repeatedly
• difficulty breathing
• trouble walking or standing
• change in pupil size (one is bigger than the other, or both are abnormally enlarged)
• slurred speech or difficulty speaking
• noticeable bruising or a large bump anywhere on head

• The skin is split open and might need stitches. 
• The headache becomes severe. 
• Vomiting occurs 2 or more times. 
• Your child's vision becomes blurred or double. 
• Your child becomes difficult to awaken or confused. 
• Walking or talking becomes difficult. 
• Your child develops any new symptoms.