Minor Head Injuries in Children

A: For anything more than a light bump on the head, you should call your child's doctor. Your child's doctor will want to know when and how the injury happened and how your child is feeling.

If your child is alert and responds to you, the head injury is probably mild and usually no tests or x-rays are needed. Your child may cry from pain or fright, but this should last no longer than 10 minutes. You may need to apply a cold compress for 20 minutes to help the swelling go down and then watch your child closely for a time.

A: If there are any changes in your child's condition, call your child's doctor right away. You may need to bring your child to the doctor's office or directly to the hospital. The following are signs of a more serious injury:

• A constant headache, particularly one that gets worse

• Slurred speech or confusion

• Dizziness that does not go away or happens repeatedly

• Extreme irritability or other abnormal behavior

• Vomiting more than 2 or 3 times

• Stumbling or difficulty walking

• Oozing blood or watery fluid from the nose or ears

• Difficulty waking up or excessive sleepiness

• Unequal size of the pupils (the dark center part of the eyes)

• Double vision or blurry vision

• Unusual paleness that lasts for more than an hour

• Convulsions (seizures)

• Difficulty recognizing familiar people

• Weakness of arms or legs

• Persistent ringing in the ears

A: If your child loses consciousness, call 911. Special tests may need to be done as soon as possible to find out how serious the injury is. If the test results are normal, you will need to watch your child closely for a time. Your child's doctor will let you know if this can be done at home or in the hospital. If you take your child home and her condition changes, call your child's doctor right away because more care may be needed.

A: A CT (computed tomography) scan is a special type of x-ray that gives a view of the brain and the skull. It is painless. A CT scan is available at almost every hospital.

A: Head x-rays can show fractures (bone breaks) of the skull, but do not show if there is a brain injury. CT scans can show brain injury and may be helpful in deciding the seriousness of the injury. They can even show very minor injuries that may not need treatment.

A: More tests will probably be needed, and your child's doctor may want a head injury specialist to examine your child.

A: You or another responsible adult should stay with your child for the first 24 hours and be ready to take your child back to the doctor's office or hospital if there is a problem. Your child may need to be watched carefully for a few days because there could be a delay in signs of a more serious injury.

It is OK for your child to go to sleep. However, your child's doctor may recommend that you check your child every 2 to 3 hours to make sure he moves normally, wakes enough to recognize you, and responds to you.

If medicine is prescribed, follow the directions carefully. Do not give pain medicine, except for acetaminophen, unless your child's doctor says it is OK. Your child's doctor will let you know if your child can eat and drink as usual.

A: If your child gets worse, call 911. Your child's doctor also may talk with a specialist or admit your child to the hospital for closer observation.

Call your child's doctor or return to the hospital if your child experiences any of the following:

• Vomits more than 2 or 3 times

• Cannot stop crying

• Has a worsening headache

• Looks sicker

• Has a hard time walking, talking, or seeing

• Is confused or not acting normally

• Becomes more and more drowsy, or is hard to wake up

• Seems to have abnormal movements or seizures or any behaviors that worry you

A: If your child does well through the observation period, there should be no long-lasting problems. Remember, most head injuries are mild. However, be sure to talk with your child's doctor about any concerns or questions you might have.