Head injuries fall into two categories:
- external (usually scalp) injuries
- 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 brain.
External (Scalp) Injury
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 disappear.
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:
- won't stop crying
- complains of head and neck pain
- becomes difficult to console
- isn't walking normally
- 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 breathing.
- 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), rouse 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.