Child Brain Injury
Head injuries occur commonly in childhood. Most head injuries are mild and not associated with brain injury or long-term complications. Very rarely, children with more significant injuries may develop serious complications (eg, brain injury or bleeding around the brain).
The parent(s) of a child with a head injury should work with their child’s healthcare provider to determine if the child needs to be evaluated, how to monitor for signs or symptoms of worsening, and develop a plan for minimizing the risk of future injuries.
Falls are the most common cause of minor head injury in children, followed by motor vehicle crashes, pedestrian and bicycle accidents, sports-related trauma, and child abuse. The risk of brain injury varies with the severity of the trauma.
Low force injuries (eg, short falls, hit by low speed or soft object such as toy or ball) have a low risk of brain injury.
In comparison, incidents that have a higher risk of brain injury include:
- High speed motor vehicle accidents,
- Falls from great heights,
- Being hit by a high speed, heavy, or sharp object (eg, baseball bat, golf club, bullet, knife).
- Inflicted injury (abuse), such as vigorous shaking, typically causes severe injury.
SIGNS AND SYMPTOMS
A child’s behavior and symptoms after a head injury depend upon the type and extent of the injury. The most common signs and symptoms include:
- Scalp swelling: This is common because there are many blood vessels in the scalp. If the skin is not broken, it is common to develop a large lump from bleeding or swelling under the skin.
- Loss of consciousness: Only about 5 percent of children with a mild head injury pass out (lose consciousness), usually just for a brief period (less than one minute).
- Headache: Headache occurs in about 20 percent of children after head injury. In children who are too young to speak, irritability may be an indication of headache or other discomfort. (See “Patient information: Headache in children”).
- Vomiting: Approximately 10 percent of children have at least one episode of vomiting after a head injury. Children who vomit after a head injury do not necessarily have a serious brain injury.
- Seizures: Less than one percent of children have a seizure immediately after a head injury. A few of these children have a serious head injury. As a result, a CT scan is usually recommended in this situation. (See “Imaging tests” below).
- Concussion: The term concussion is used to describe a mild form of traumatic brain injury. Common symptoms of a concussion include confusion, amnesia (not being able to remember events around the time of the injury), headache, vomiting, and dizziness. Loss of consciousness does not always occur.