Approach to Head Injury in Children

Most infants and children who have had isolated minor trauma can be observed at home, after evaluation considered LOW RISK if:

a) Trivial mechanism of injury.

b) No symptoms.

c) Normal Clinical exam.

Most common causes of Head Injury in children are:

 a) Falls

b) Car accidents

c) Sport

d) Physical abuse

Most children recover without problems, but some can have serious problems.

A concussion is a mild form of a brain injury.

You should see a doctor immediately if:

a) Fall from higher than 1meter (3-5 feet)

b) Younger than 6 months of age

c) Throws up more than once – especially if after 6 hours

d) Loss of Consciousness/ seizures

e) Bad headache – especially if getting worse

f) Has trouble walking, talking, seeing or generally behaving differently

g) Dizziness

h) Blood or watery fluid from nose /ears

i) Cut that are bleeding after 10 minutes especially if you have applied pressure.

j) Extreme crankiness

k) Trouble waking up

l) Was hit by something moving very fast or (especially in a child under 6 months) develops a big swelling or forehead.

m) If your child has been crying badly after the fall – and wants to sleep- let him/her have a brief nap – then wake and reassess.

Consider giving some pain relief such as paracetamol (Brand name: Panado, Calpol or Ibuprofen Brand name: Nurofen Jr).

We have strict criteria for CT scanning as this is radiation (even in a small dose) – and most children with minor Head Injuries who are behaving well, and have no physical signs, will not need one.