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Head injuries in children - when to see a doctor immediately?

Head injuries in children - when to see a doctor immediately?

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Head injuries are one of the most common reasons for parents and children coming to the hospital, as well as hospitalization of the youngest children. In Poland, it is over 40,000 cases a year. From this it follows that, most likely, each parent will sooner or later have to face a difficult situation, which is the occurrence of a head injury in their child. That is why we have prepared for our readers a short guide that will help you get used to this topic a bit. It will tell you how to behave in such a situation and what symptoms should particularly alarm the parent and when to call for help. Head injuries in children from A to Z.

What are head injuries in children?

Head injuries occur most often due to the action of mechanical force on structures located within the anatomical area of ​​the head. As a rule, injuries are divided into light, medium heavy and heavy depending on the occurrence of consciousness disorders, their duration and subsequent disorders.

No matter how severe a child's head injury is, it can never be underestimated because the condition after the injury can change very quickly and can be dangerous to the health or life of the toddler. In addition to the direct consequences of injury are also a big problem post-traumatic syndromes, the effects of which can be long-lasting and very bothersome.

Management of head injuries in children

Although the head trauma in children is not always so serious that it should be assessed by a specialist in the hospital, every parent should know when it is imperative to call for help.

Parent, call an ambulance if:

  • The child lost consciousness, is weak, lies down, cannot stand up.
  • Seizures, speech or vision disturbances (e.g. double vision or visual field defect) and persistent vomiting have occurred in the child after the injury.
  • The child after injury has problems understanding and saying words. There is incomprehensible, indistinct speech, random statements. Has problems with reading and writing and making precise movements.
  • Your child has difficulty walking and balance
  • The injury occurred as a result of high force. For example, it was a fall from a height of more than 1 meter or 5 or more stairs, a collision, a car or traffic accident.
  • You will notice a leakage of transparent fluid from the ears or nose, bruising or hematoma in the ear region (one-sided or bilateral). There will be a hematoma around the eyes (so-called spectral hematoma) without noticeable soft tissue bruising in the eye area, bleeding from the ears (one or both at once), the presence of large hematomas of the skull and large deep wounds of the skin and skull bones.

In the above cases, immediately seek medical attention.

Later effects of the injury

In some cases, disturbing symptoms may not appear until some time after the accident:

  • Memory disorders involving the circumstances of the event or preceding it, and other memory disorders. For example, the inability to remember simple words 5 minutes after hearing them, repeatedly asking the same questions, difficulty naming objects.
  • Severe headaches, particularly persistent and worse, and combined with nausea and dizziness.
  • Vomiting only occurs after a few hours after the injury.
  • Sudden loss of consciousness or disturbance of consciousness occurring several hours after the accident
  • Excessive agitation
  • Problems with concentration, blurred vision and visual acuity.

If such symptoms occur, the child should remain as the fastest to be examined by a specialist in a hospital.
Immediate medical consultation after head injuries is also required for children with coagulation disorders and when taking anticoagulants - in their case, head injury can cause serious intracranial haemorrhage.

Medical management of head injuries in children

If your child has these symptoms, it means that a medical assessment of the extent of head injury and the condition of the injured child is necessary.

In such cases, the child's general condition and appearance are first assessed. Attention is paid to the child's behavior, visible wounds and position. Then his vital functions (pulse, pressure, respiration rate) and pupillary reflexes are assessed. The latter aims to capture the symptoms of increasing intracranial pressure due to e.g. intracranial bleeding.

In some cases, the doctor may order additional tests, e.g. CT of the head or ultrasound (if the fontanella has not yet grown), as well as blood tests.

Depending on the child's condition, it may be necessary to be observed in hospital or hospitalized for the causes of the symptoms associated with the injury, e.g. convulsions or visual and speech disorders.
Head injuries in children are very common, but thankfully in the vast majority of cases they turn out to be harmless. Nevertheless, you should remember in which situations after the injury you should call for help and when it is worth consulting a doctor. Even if the head injury was not serious, it is worth closely observing the child's behavior and condition. To be able to react appropriately in the event of disturbing symptoms.

Based on: Hilger T., Bagłaj M., Zagierski J. et al .: Light head trauma in children, clinical algorithm proposal. Developmental Medicine, 2010; 1: 28-36