Head Injuries

Hilliard Pediatrics, Inc. - Dr. Tim Teller, MD


Introduction


Head injuries are very common in children. They are certainly frightening for both children and parents. Many head injuries cause immediate swelling and sometimes bruising at the site of the injury. The swelling can be helped by applying an ice pack to that area for 10-15 minutes 2-4 times a day while the swelling remains. Realize that the ice pack is not medically necessary, and many children strongly dislike it. Swelling over the skull is not a cause for concern, even if it comes up immediately, as long as the bones feel firm (not spread apart or indented) underneath the area. If there is a small scratch or abrasion, a bandage and antibiotic ointment (such as Neosporin ® may be applied. If there is a larger cut, especially one that bleeds, call us to discuss whether stitches or other treatment will be needed. We recommend Children's Hospital ER or Children’s Hospital Close To Home Urgent Care facilities for those children needing stitches. During regularly scheduled office hours, we are able to treat some (not all) cuts with a "medical glue" (Dermabond® that avoids stitches. For those children who appear to be otherwise fine after the head injury, simple observation at home is recommended.


Treatment


Many children with a mild head injury will complain of a headache, be grouchy or irritable, and perhaps vomit once or twice. These children can be given Tylenol® or Motrin® and clear liquids (if vomiting has occurred) while being closely observed for the next 24 hours. If these symptoms have occurred, wake your child up every 2 to 4 hours during naptime or overnight. They should be able to respond to you normally (recognize you, respond when you talk to them, etc.). If they do not respond to you normally, they should be promptly seen at the Children’s Hospital Emergency Department (not the Urgent Care). It is not necessary to awaken a child overnight if they are acting normally prior to bedtime or naptime.

A child needs to be seen right away at the Children’s Hospital Emergency Department (not the Urgent Care) if after a head injury they lose consciousness, have extreme irritability, extreme headache, vomiting 3 or more times, bleeds from their ears, has a seizure, has blurry or double vision, has weakness on one side of their body, or does not respond to you normally. Also a child needs immediate attention if the bones of the skull feel soft, indented, or split apart where the injury occurred. 

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