Head injury: Treatment in Infants and Young Children

What's in this article?

1 Head Injury First Aid
2 What Are the Signs and Symptoms of a Brain Injury?
3 Head Injury in Infants and Young Children
4 Treating a severe head injury

A head injury is any sort of injury to your brain, skull, or scalp. This can range from a mild bump or bruise to a traumatic brain injury. Common head injuries include concussions, skull fractures, and scalp wounds. The consequences and treatments vary greatly, depending on what caused your head injury and how severe it is.

Head injuries may be either closed or open. A closed head injury is any injury that doesn’t break your skull. An open, or penetrating, head injury is one in which something breaks your skull and enters your brain.

It can be hard to assess how serious a head injury is just by looking. Some minor head injuries bleed a lot, while some major injuries don’t bleed at all. It’s important to treat all head injuries seriously and get them assessed by a doctor.

Head Injury First Aid

A head injury is any trauma to the scalp, skull, or brain. The injury may be only a minor bump on the skull or a serious brain injury.

Head injury can be either closed or open (penetrating).

A closed head injury means you received a hard blow to the head from striking an object, but the object did not break the skull.
An open, or penetrating, head injury means you were hit with an object that broke the skull and entered the brain. This is more likely to happen when you move at high speed, such as going through the windshield during a car accident. It can also happen from a gunshot to the head.

Head injuries include:

Concussion, in which the brain is shaken, is the most common type of traumatic brain injury.
Scalp wounds
Skull fractures

Head injuries may cause bleeding:

In the brain tissue
In the layers that surround the brain (subarachnoid hemorrhage, subdural hematoma, extradural hematoma)

Head injury is a common reason for an emergency room visit. A large number of people who suffer head injuries are children. TBI (traumatic brain injury) accounts for over 1 in 6 injury-related hospital admissions each year.

What Are the Signs and Symptoms of a Brain Injury?

Signs of a TBI include:

Confusion
Depression
Dizziness or balance problems
Double or fuzzy vision
Feeling foggy or groggy
Feeling sluggish or tired
Headache
Memory loss
Nausea
Sensitivity to light or noise
Sleep disturbance
Trouble concentrating
Trouble remembering

Indications that a head injury is more serious than a concussion and requires emergency treatment include:

Changes in size of pupils
Clear or bloody fluid draining from the nose, mouth, or ears
Convulsions
Distorted facial features
Drop in blood pressure
Facial bruising
Fracture in the skull or face
Impaired hearing, smell, taste, or vision
Inability to move one or more limbs
Irritability
Loss of consciousness
Low breathing rate
Restlessness, clumsiness, or lack of coordination
Severe headache
Slurred speech or blurred vision
Stiff neck or vomiting
Sudden worsening of symptoms after initial improvement
Swelling at the site of the injury
Persistent vomiting

Head Injury in Infants and Young Children

Infants often visit health care practitioner because of a head injury. Toddlers tend to fall as they learn to walk, and falls remain the number one cause of head injury in children. While guidelines exist regarding the evaluation of head injury victims, they tend to be applied to those older than 2 years of age.

A minor head injury in an infant is described by the American Academy of Pediatrics as the following: a history or physical signs of blunt trauma to the scalp, skull, or brain in an infant or child who is alert or awakens to voice or light touch.

Infants are usually unable to complain about headache or other symptoms. Therefore, basic guidelines as to when to seek medical care can include the following:

Altered mental status. The child is not acting or behaving normally for that child.
Vomiting
Scalp abnormalities including lacerations and swelling that may be associated with skull fracture Forehead contusions tend to be less worrisome than occipital (back of the head) contusions
Seizure

Often a careful physical examination is all that is needed to assess the infant’s risk for intracranial hemorrhage, but some testing may be considered.

CT scan may be indicated based upon the health care practitioner’s assessment of the child. Plain skull X-rays may be considered to look for a fracture, as a screening tool to decide about the need for a CT scan.