Head Injuries

As motor skills progress from sitting up to crawling, pulling to stand, walking, and running, head injuries become incredibly common. Try as you might to pad the sharp corners and edges in your home, kids always seem to find the one spot you missed. From the loud noise the impact makes, to the giant goose eggs that form, bumps to the head can be very scary for parents. Fortunately, they are very rarely dangerous, and there are just a few simple things you can look for to rule out a serious head injury.

Mechanism of Injury

  • This is the most important indicator of a dangerous head injury, and if the mechanism of injury is not serious, there is very low risk of danger for your baby.
  • Serious mechanisms of injury include the following:
    • High speed injury, for example from a bicycle or motor vehicle accident. Your child is fast, but can’t run fast enough to be labeled “high speed.”
    • Injury from a hard projectile, such as a golf club or baseball bat.
    • Fall from a great height:
      • 3 feet or higher for a child under two years old.
      • 5 feet or higher for a child older than two years old.

Persistent or Worsening Vomiting

  • Persistent and worsening vomiting is the key here.
  • Children will often vomit once or twice after a fall, usually due to hard crying, or simply because kids vomit sometimes.

Loss of Consciousness

  • We always ask parents if the baby cried right away to make sure they did not lose consciousness.
  • If they cried right away, then we know there was no loss of consciousness.

Altered Mental Status

  • Examples of altered mental status include a child who:
    • has a seizure after a head injury.
    • does not recognize parents or surroundings.
    • is clearly off balance compared to normal.
    • is Clinically lethargic

Size of the Bump

  • The size of the bump is not a good way to identify a dangerous head injury, and is not something we ask parents about.

Management

  • If none of these dangerous mechanisms or symptoms are present, you can let them sleep and play normally without interrupting to check on them.
  • Ibuprofen (if older than 6 months) and acetaminophen are helpful if your child seems more fussy after the head injury.
  • Most children will resist a cold or ice pack on their injury, and you don’t need to fight them on this since the swelling will heal on its own with time.