fall into two categories:
- external (usually
- internal head injuries,
which may involve the skull, the blood
vessels within the skull, or the brain
Fortunately, most childhood falls or blows to
the head result in injury to the scalp only,
which is usually more frightening than
threatening. An internal head injury could have
more serious implications because the skull
serves as the protective helmet for the delicate
The scalp is rich with blood vessels, so even
a minor cut there can bleed profusely. The
"goose egg" or swelling that may appear after a
head blow is the result of the scalp's veins
leaking fluid or blood into (and under) the
scalp. It may take days or even weeks to
What to look for and what to do:
Call the doctor if your child is an
infant; has lost consciousness, even
momentarily; or if a child of any age has
any of these symptoms:
If your child is not an
infant, has not lost
consciousness, and is alert and behaving
normally after the fall or blow:
Apply an ice pack or instant cold
pack to the injured area for 20 minutes.
If you use ice, always wrap it in a
washcloth or sock; ice applied directly
to bare skin can cause frostbite.
Observe your child carefully for the
next 24 hours. If you notice any of the
signs of internal injury (see below),
call your doctor immediately.
If the incident has occurred close
to bedtime or naptime and your child
falls asleep soon afterward, check in
every few hours to look for twitching
limbs or disturbances in color or
If color and breathing are
normal, and you observe or sense no
other abnormalities, let your child sleep
(unless the doctor has advised otherwise).
There's no need to keep a
child awake after a head injury.
If color and/or breathing are
abnormal, or if you aren't
comfortable with your child's appearance
(trust your instincts), arouse your child
partially by sitting him or her up. Your
child should fuss a bit and attempt to
resettle. If he or she doesn't protest, try
to awaken your child fully. If your child
can't be awakened or shows any signs of
internal injury (see below), call the doctor
or an ambulance.
The brain is cushioned by cerebrospinal
fluid, but a severe blow to the head may knock
the brain into the side of the skull or tear
blood vessels. Any internal head injury —
fractured skull, torn blood vessels, or damage
to the brain itself — can be serious and
possibly life threatening.
Different levels of injury require different
levels of concern. It can be difficult to
determine the level of injury, so it's always
wise to discuss a head injury with your doctor.
A clear indicator of a more serious injury is
when a child loses consciousness or has signs of
What to Look for and What to Do
Call an ambulance if your child shows any of
- abnormal breathing
- obvious serious wound or fracture
- bleeding or clear fluid from the nose,
ear, or mouth
- disturbance of speech or vision
- pupils of unequal size
- weakness or paralysis
- neck pain or stiffness
- vomiting more than two to three times
- loss of bladder or bowel control
If your child is unconscious:
- Do not try to move your
child in case there is a neck or spine
- Call for help.
- If you've been trained in CPR, follow
the recommendations if they're appropriate.
- Turn a child who is vomiting or having a
seizure onto his or her side while trying to
keep the head and neck straight. This will
help prevent choking and provide protection
in case of neck and spine injury.
- If there's swelling, apply an ice pack
or cold pack.
If your child is conscious:
- Do your best to keep your child calm and
- If there's bleeding, apply a sterile
- Do not attempt to
cleanse the wound, which may aggravate
bleeding and/or cause serious complications
if the skull is fractured.
- Do not apply direct
pressure to the wound if you suspect the
skull is fractured.
- Do not remove any
object that's stuck in the wound.
Concussions are also a type of internal head
injury. A concussion is the temporary loss of
normal brain function due to an injury. Repeated
concussions can result in permanent injury to
the brain. However, it's possible to get a
concussion that's mild and just requires
One of the most common reasons kids get
concussions is through sports, so make sure they
wear appropriate protective gear and don't
continue to play if they've had a head injury.
If your child sustains an injury to the head,
watch for these signs of a possible concussion:
- "seeing stars" and feeling dazed, dizzy,
- memory loss, such as trouble remembering
what happened right before and after the
- nausea or vomiting
- blurred vision and sensitivity to light
- slurred speech or saying things that
don't make sense
- difficulty concentrating, thinking, or
- difficulty with coordination or balance
(such as being unable to catch a ball or
other easy tasks)
- feeling anxious or irritable for no
- feeling overly tired
If you suspect a concussion, call your doctor
for further instructions.
It's impossible to prevent kids from ever
being injured, but there are ways to help
prevent head blows.
Make sure that:
- your home is childproofed to prevent
your kids always wear appropriate
headgear and safety equipment when biking,
in-line skating, skateboarding, snowboarding
or skiing, and playing contact sports.
Wearing a bike helmet, for instance, reduces
the risk of concussion by about 85%.
- kids always use a seat belt or child
your child takes it easy after a head
injury, especially after a concussion, and
doesn't go back to rough play or playing
sports until the injury has healed. (If your
child reinjures the brain while it's still
healing, it will take even more time to
completely heal. Each time a person has a
concussion, it does additional damage.)