Heads Up on Head Injury in Children

Head Injury Article

If you are a parent of young children, it is likely that you are hugely fearful of your child suffering a severe blow to the head. This is understandable, as children are highly susceptible to falls and bumps, especially when they are under the age of 14.

Furthermore, studies have shown that up to 4% of children who have had a seemingly mild head injury will develop complications (Continuing Medical Education, Vol. 31, no.3). It’s a really minor percentage, especially when you consider that only 5% of people in South Africa (adults and children) sustain serious head injuries. Nevertheless, even the smallest chance of this happening to your child is very scary.

From babies who accidentally fall off a changing table, to children who fall off a skateboard or bicycle, or boys who bash heads in a rugby scrum, parents need to take a blow to the head seriously and seek medical help if there are any grounds for concern.
Head injuries can take several forms. A mild injury may be a bruise, an egg-shaped swelling or a shallow cut on the head. More serious injuries include concussion, a deep head wound or even a fractured skull bone. A severe injury is likely to involve internal bleeding or damage to the brain.

When to see your doctor:

If your child has sustained a blow to the head, how will you know that he or she should see a doctor?
Fortunately, most bumps will cause, at worst, a bruise with some swelling – which can be remedied with a kiss and cuddle and some physical rest, or an icepack on the bruise. Within hours, or even minutes, the child will back at play again.
However, a more serious blow will cause symptoms that parents should be aware of. These are the warning signs to watch out for:

Signs that the child should be monitored:

● Headache, sensitive to light and noise, irritable
● Confused or dizzy, balance is poor, struggling to concentrate
● Feeling nauseous
● Feeling tired
● Blurred vision or eyes feel tired

Watch the child carefully and see a doctor if there is no improvement within 24 hours. Trust your instincts. If you aren't comfortable with your child's appearance, call your doctor.

Signs that your child should see a doctor:

● “Seeing stars" and feeling dazed, dizzy, or lightheaded
● Trouble remembering what happened right before and after the injury
● Nausea and vomiting
● Headache won’t go away
● Neck stiffness or pain
● Blurred vision and sensitivity to light
● Slurred speech or saying things that don't make sense
● Problems concentrating, thinking or making decisions
● Difficulty with coordination or balance (such as being unable to catch a ball or other easy tasks)
● Feeling anxious or irritable for no apparent reason

These symptoms usually indicate a concussion. A concussion is a temporary loss of normal brain function and in most cases is mild and won’t cause long-term damage. Children with a mild concussion will need to take a break from physical activity for a week or two and give the head a chance to rest.

When to take your child to the emergency room:

● The child is unconscious
● The child is experiencing seizures or convulsions
● Blood or clear fluid is draining from the ears or nose
● The pupil in one eye looks larger than the other
● There is a deep wound or laceration in the scalp
● Pale and sweating
● Slurred speech and behaviour changes
● Struggling to walk or weak on one side of the body

Besides the obvious distress the child may be experiencing, these symptoms also suggest that the child will need an expert assessment of the extent of the injury.

Treatment and recovery:

In most cases, applying an ice pack or Arnica to a bump on the head is sufficient.

● Rest is also important. Avoid rough play or sports for a couple of days or until the doctor says it’s OK.
● Getting plenty of sleep while the brain is healing is vital.
● For recovery from concussion, mental rest is also important, which means restricting both homework and video games! Get your doctor’s advice on this.
● Severe injury will need medical supervision. The child may need stitches in the head, a period of hospitalisation, moderate sedation, and assistance with breathing, or even surgery.

Precautions and prevention:

It's impossible to completely prevent an injury, but you can do a lot to protect your child from severe head blows. These simple precautions will go a long way towards protecting your child:

● Childproof your home and ensure a safe playing environment to prevent household accidents. For instance, soften the corners or surfaces that your child may bump into and put heavy objects that could fall easily out of harm’s way. Provide a cushioned surface under play equipment. A garden lawn is still the cheapest and most effective option, but specialised artificial surfaces or playground sand also work very well.
● When driving, always use a child safety seat or seat belt.
● Ensure that children wear helmets when they’re on anything with wheels, such as a tricycle, bicycle, roller skates or skateboard.
● Ensure that children wear safety headgear when playing contact sports like rugby or boxing, or when playing cricket or baseball. Even hockey sticks can be hazardous.

For more information or in the case of a medical emergency, please contact:
IPSS Medical Rescue on emergency number +27 (0) 823 911 911

Disclaimer: Any information contained here is merely a guideline. Always visit your healthcare practitioner for any health-related advice or diagnosis.

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