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The information provided by The Pediatric Group, PLLC website is information of a general nature and is intended for informational purposes only. It should not be relied on for personal medical reasons and should not be relied upon as providing specific medical advice or for diagnosis or treatment. All information contained on this website is presented as is, without any warranties of any kind, express or implied.

Please note that visiting this website alone does not establish a physician-patient relationship with any physician engaged by The Pediatric Group, PLLC. You should consult your own physician for specific advice for your own personal situation.
Last update:
September 03. 2010 14:58:54

Head Injury

Definition:  A normally active child will likely fall and hit his/her head at least once during childhood.  Most of the time these injuries are not serious, but they can be frightening for both parent and child. 

A child who has experienced a head injury, even one that appears to be minor, must be observed by a responsible adult who will watch carefully during the next 2 hours for serious symptoms to appear.  Mild headache, mild dizziness, and nausea are common symptoms and not necessarily signs of danger.  Encourage the child to lie down and rest until all symptoms have cleared.  Allow the child to sleep if he/she wants to, but keep him/her nearby.  Awaken the child after 2 hours of sleeping to check to make sure he/she can walk and talk normally, and can tell you his name and where he is.

Most head impacts only cause a scalp injury. Click here for scalp wound care.

Injuries to the head fall into four categories:
  1. Scalp injury: A cut, scrape, bruise or swelling to the skin over the head.  Big lumps can occur with scalp injury.  See below for home care for scalp injury.
  2. Skull injury: Bruises or fracture to the bones of the head.
  3. Concussion: Brief periods of confusion, amnesia, or altered mental status after trauma.  The diagnosis of concussion does not require a loss of consciousness.
  4. Brain trauma: Indicated by acute neurological symptoms: 
    • child is difficult to awaken OR
    • child shows confused thinking and talking OR
    • child’s speech is slurred OR
    • child’s arms are too weak to lift objects which would normally be easy OR
    • child cannot walk steadily, but staggers, trips, or stumbles.
    • child vomits repeatedly.
    • child’s pupils (the black center of the eye) are very obviously different sizes.
Call 911 if any of the following occur:
  1. Acute neurological symptoms described above persist for longer than 10 minutes.
  2. Your child has a seizure.
  3. Your child was knocked unconscious for more than 1 minute.
  4. Your child cannot move his/her neck normally (and this started within an hour of the incident) or
  5. Your child has major bleeding that can’t be stopped.

Call our office urgently if:
  1. Your child is less than three months old.
  2. Your child is less than 24 months old and is now fussy or crying.
  3. The skin at the injury site is split open or has a large, deep cut.
  4. Your child has vomited three or more times since the injury.
  5. There is watery fluid dripping from the nose or ear while your child is not crying.
  6. Your child’s vision is blurry for more than 5 minutes.
  7. There is a large swelling that measures
    • more than 1 inch for under age 12 months;
    • more than 2 inches for older than 12 months of age;
    • OR that is getting bigger.
  8. Your child was knocked unconscious for less than 1 minute.
  9. Your child has a severe headache or crying that is not improved after applying a cold pack for at least 20 minutes.
  10. The injury was caused by high speed (motor vehicle accident), great height (twice the child’s height), or blows from a hard object (sports implement such as baseball bat or golf club).
  11. Your child can’t remember what happened (amnesia)
  12. Your child demonstrated any one of the acute neurological symptoms above but now is fine.
Call our office during regular hours if:
  1. Your child has a headache that lasts for more than three days.
Home Care for Scalp Injury:
  1. Gently wash a scrape or cut with warm water.  Then apply pressure with a sterile dressing gauze pad) for 10 minutes to stop any bleeding.
  2. Apply ice in a wet washcloth or a cold pack for 20 minutes to any swelling.
  3. Offer only clear fluids to drink in case of nausea.  After two hours, regular foods are okay.
  4. Don’t give pain medication until you are certain your child can hold down food.  Then you may give Tylenol as directed for your child’s weight.
  5. For the next night, awaken your child every 4 hours.  See if his/her pupils (black center of the eye) are the same size.  To make sure he’s mentally clear (not confused) ask him to name familiar persons or toys.  You might want to sleep in your child’s room during this time.

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