Head Injury

Types of Head Injuries

• Scalp Injury. Most head injuries only damage the scalp. Examples are a cut, scrape, bruise or swelling. It is common for children to fall and hit their head while growing up. This is especially common when a child is learning to walk. Big lumps (bruises) can occur with minor injuries. This is because there is a large blood supply to the scalp. For the same reason, small cuts on the head may bleed a lot. Bruises on the forehead sometimes cause black eyes 1 to 3 days later. This is caused by blood spreading downward by gravity.
• Skull Fracture. Only 1% to 2% of children with head injuries will get a skull fracture. Most often, there are no other symptoms except for a headache. The headache occurs at the site where the head was hit. Most skull fractures occur without any injury to the brain. They heal easily.
• Concussion. A concussion is a type of brain injury. It causes a change in how the brain works for a short time. It is usually caused by a sudden blow or jolt to the head. Most children bump or hit their heads without causing a concussion. The most common signs are a brief period of confusion or memory loss. This happens after the injury. Other signs of a concussion can include a headache or vomiting. Dizziness or acting dazed can also be signs. A person does not need to be knocked out to have had a concussion. Following a concussion, some children have ongoing symptoms. These can include headaches, dizziness or thinking difficulties. School problems or emotional changes can occur. These symptoms can last for several weeks.
• Brain Injuries (Serious) are uncommon. This includes bleeding, bruises or swelling within the brain. They are suspected by the symptoms listed below:
• Hard to wake up or keep awake or
• Acts or talks confused or
• Slurred speech or
• Weakness of arms or legs or
• Walking is not steady.
• These symptoms are an emergency. If they happen, call 911.

Concussion Treatment

• Treating a concussion requires both Physical Rest and Brain Rest.
• Brain rest means a gradual return to full studying and school attendance.
• Physical rest means a gradual return to normal activity, work and gym class.
• If symptoms occur (like a headache), the child needs to return to the previous level of physical and mental activity. In 24 hours, they can try again to take it to the next level.
• Athletes involved in sports need to have a stepwise plan for "return to play." Progressing through stages should be supervised by a doctor or athletic trainer.

Pain Scale

• Mild: your child feels pain and tells you about it. But, the pain does not keep your child from any normal activities. School, play and sleep are not changed.
• Moderate: the pain keeps your child from doing some normal activities. It may wake him or her up from sleep.
• Severe: the pain is very bad. It keeps your child from doing all normal activities.

1. What You Should Know About Mild Head Injuries:
   • Most head injuries only cause a swelling or bruise to the scalp.
   • The main symptom is pain.
   • Swelling of the scalp does not mean there is any swelling of the brain. The scalp and brain are not connected. They are separated by the skull bone.
   • The skull bone protects the brain from getting injured.
   • Big lumps or bruising can occur with minor injuries to the scalp. This is normal. Reason: the scalp has a large blood supply.
   • The mildest brain injury is a concussion. Most of those also turn out fine.
   • Here is some care advice that should help.
2. Wound Care:
   • If there is a scrape or cut, wash it off with soap and water.
   • For any bleeding, put direct pressure on the wound. Use a gauze pad or clean cloth. Press for 10 minutes or until the bleeding has stopped.
3. Cold Pack For Swelling:
   • Use a cold pack or ice bag wrapped in a wet cloth. Put it on any swelling. Do this for 20 minutes.
   • Reason: Prevent big lumps ("goose eggs"). Also, helps with the pain.
   • Repeat in 1 hour, then as needed.
4. Watch Your Child Closely for 2 Hours:
   • Watch your child closely during the first 2 hours after the injury.
   • Have your child lie down and rest until all symptoms have cleared. Note: mild headache, mild dizziness and nausea are common.
   • Allow your child to sleep if he wants to, but keep him nearby.
   • Wake him up after 2 hours of sleeping. Check that he is alert and knows who you are. Also, check that he can talk and walk normally.
5. Diet - Start With Clear Fluids:
   • Offer only clear fluids to drink, in case he vomits.
   • Allow a regular diet after 2 hours.
   • Exception: babies can continue breastfeeding or formula.
6. Pain Medicine:
   • To help with the pain, give an acetaminophen product (such as Tylenol). Another choice is an ibuprofen product (such as Advil). Use as needed.
   • Exception: Do not give until 2 hours have passed from injury without any vomiting.
   • Caution: Never give aspirin to children and teens. Reason: Always increases risk of bleeding.
7. Special Precautions For 1 Night:
   • Mainly, sleep in same room as your child for the first night.
   • Reason: If a problem occurs, you will recognize it if you are close by. Problems include a bad headache, vomiting or confusion. Also, look for any change in your child's normal behavior.
   • Option: If you are worried, wake your child once during the night. Check how he walks and talks.
   • After 24 hours, return to a normal sleep routine.
8. What to Expect:
   • Most head trauma only causes a scalp injury.
   • The deep headache usually clears in 24 hours.
   • The scalp pain at the site of impact may last 3 days.
   • The swelling may take a week to go away.
9. Call Your Doctor If:
   • Pain or crying becomes severe
   • Vomits 2 or more times
   • Your child becomes hard to wake up or confused
   • Walking or talking is not normal
   • Headache lasts more than 24 hours
   • You think your child needs to be seen
   • Your child becomes worse