Head Injury Fears, Myths, Precautions

People used to have difficulty naming their fears about when their child hit their head.  Now their fear has a name- Natasha Richardson.  Everyone has heard a story like the famous actress's.  A person hit their head, looked well at first, then did not wake up in the morning.  Fortunately, this story of delayed death after head injury is rare in adults.  It is almost unheard of in kids.  When children hit their head the severity is obvious right away.  They come to the ED in two distinct presentations- still unconscious and obviously very sick; or they come in awake, alert, and essentially well. When can you stay home with your head-injured child then, and avoid a costly and time-consuming ED visit?  Here are the good signs:  your child was not "knocked-out," his fall was from a distance less than three times his own height, he has no vomiting, and he has no headache.  Some toddlers will get sleepy after crying their hearts out from their sore head.  That is OK- you can let your child sleep, as long as she has not vomited, has drank a little, and acted "with it" since the injury.  After an hour or two, if your child has not awakened, you should wake her up to be sure she walks and acts normally. What about when baby falls off the bed or out of the car seat and hits her head?   Babies are a little different than older kids- they get skull fractures more easily.  A baby under a year old who hits her head should get checked out if she has any swelling on her scalp.  Of course, she also needs to be seen if she has any loss of consciousness, vomiting, or acts "out of it." What if your child was knocked out, is vomiting, or complains of a headache?  Certainly bring him in to get checked out, but don't panic.  Most of those kids have a concussion but not a bad brain bruise or brain bleeding.  A concussion is when the patient get "his bells rung."  He feels tired, sick to his stomach, has a headache.  After a normal CT scan, if he can drink without vomiting, he can go home.  The concussion might last for days.   The one really important precaution for concussions is that the patient must not take a risk of hitting their head again while they are sick.  The child must not do sports or other risky activity until cleared by their own doctor in a follow-up exam. Have a head injury story of your own?  Feel free to tell us by clicking on the comments button and writing us.