Minor Head Injuries In Children

Almost all children bump their heads every now and then. While these injuries can be upsetting, most head injuries are minor and do not cause serious problems. In very rare cases, problems can occur after a minor bump on the head. This information, developed by The American Academy of Pediatrics, will help parents understand the difference between a head injury that needs only a comforting hug and one that requires immediate medical attention.

This information is intended for children who:

  • Were well before the injury
  • Act normally after the injury
  • Have no cuts on the head or face (this is called a closed head injury)
  • Have no other injuries to the body

This information is not intended for children who:

  • Are younger than 2 years of ageHave possible neck injuries
  • Already have nervous system problems, such as seizures or movement disorders
  • Have difficulties or delays in their development
  • Have bleeding disorders or bruise easily
  • Are victims of child abuse

Children with these above conditions may have more serious problems after a mild head injury.

What Should I Do If My Child Has A Head Injury But Does Not Lose Consciousness?

  • For anything more than a light bump on the head, you should call your pediatrician.
  • Your pediatrician 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 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 period of time.
  • If there are any changes in your child's condition, call your pediatrician right away.
  • You may need to bring your child to the pediatrician's office or directly to the hospital.

The following are signs of a more serious injury:

  • a constant headache that gets worse
  • vomiting more than two times, clumsiness or difficulty walking
  • difficulty waking up
  • extreme irritability or other abnormal behavior
  • dizziness that does not go away or happens repeatedly
  • slurred speechoozing blood or watery fluid from the nose or ear
  • sunequal size of the pupils (the dark center part) of the eyes
  • unusual paleness that lasts for more than an hour
  • convulsions (seizures)

What If My Child Loses Consciousness?

If your child loses consciousness, call your pediatrician. Special tests may need to be done as soon as possible so that your pediatrician can find out how serious the injury is.

If the test results are normal, your pediatrician will want you to watch your child closely for a period of time. Your pediatrician 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 pediatrician right away since more care may be needed.

What Kinds Of Test May Be Needed? Where Are They Done?

A CAT scan is a special type of X-ray that takes a picture of the brain and the skull. It is painless. Not every hospital can do CAT scans. Your child may need to go to a hospital that can do the scan.

What Is The Difference Between A Head X-Ray And CAT Scan?

Head x-rays can show fractures (bone breaks) of the skull, but do not show if there is a brain injury.

CAT 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.

What Happens If The CAT Scan Or Head X-Ray Shows A Problem?

More tests may be needed and your pediatrician may want a head injury specialist to examine your child.

What Should I Do If My Child Needs To Be Observed At Home?

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 pediatrician 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 okay for your child to go to sleep. However, your pediatrician may recommend that you check him or her every 2 to 3 hours to make sure he or she moves normally, wakes enough to recognize you, and responds to you.

If your pediatrician prescribes medicines, follow the directions carefully. Do not give pain medication, except for acetaminophen (Tylenol), unless your pediatrician says it is okay. Your pediatrician will let you know if your child can eat and drink as usual.

What If My Child Gets Worse?

If your child gets worse, your pediatrician will need to examine him again. If a CAT scan has not been done, your pediatrician may order one. Your pediatrician also may talk with a specialist or admit your child to the hospital for closer observation.

Call Your Pediatrician Or Return To The Hospital If Your Child Experiences Any Of The Following:

  • Vomits more than twice
  • Cannot stop crying
  • 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

Will My Child Have Any Permanent Damage From A Minor Head Injury?

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 pediatrician about any concerns or questions you might have.

The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.


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