Head injuries are common in children and for good reason: falls are part of the learning process when they start to walk. And once they are older they love to test their limits. I learnt this not long ago with my 4 year old daughter. She loves to jump and usually lands on her feet. But this time she landed on her face when she jumped off the sofa at home. A timely reminder – of what to look out for when your child suffers a bump on the head.
As soon as the accident occurs determine whether your child is conscious and look for bruises or wounds. Should your child lose consciousness or if there is an open head wound go straight to the hospital.
If your child is alert, behaving normally and only has bruises or superficial wounds, observe for the next 24 hours looking for signs of brain injuries. The child could become very tired and lethargic which is fine as long as the child remains arousable.
Is it a Concussion?
Concussion is the most common type of head injury we see in children. A concussion is a traumatic brain injury that is usually caused by a blow to the head which may cause instant loss of consciousness. But most concussions do not cause lost of consciousness, and the person or untrained observer may not recognise that a concussion has occurred. This can be difficult to determine especially in infants and toddlers as they are unable to describe how they feel.
Watch out for the following clues:
- Dazed appearance
- Listlessness and tiring easily
- Irritability, crankiness, excessive crying
- Loss of balance and unsteady walking
- Change in eating or sleeping patterns
- Bulges at the Fontanelles (soft spots on the front and back of the skull)
My daughter cried and screamed her lungs out, which was – as painful as it was to see – a good sign. Then she became very lethargic. It was a struggle to keep her awake. When she started to vomit, not only once but three times, we had to take her to the emergency department. Needless to say, emotions were running high. At the hospital a CT scan was ordered to rule out collection of blood within the skull which could lead to serious complications if left unattended.
After the bump
Fortunately, the scan returned normal and my daughter was allowed to go home. The emergency doctor told us that she may well be back on her feet in as early as two days as symptoms could last for only a few days but may also take weeks or months to resolve. It is important that the child gets enough rest, minimal screen time and avoids sports, especially contact sports, in the first few days. It is recommended that they return to regular routine as early as possible as research has shown that they recover more quickly with activities than with rest only. If concussion symptoms last for months or longer and daily routine is effected, they may be suffering from Post-Concussive Syndrome. While uncommon after only one concussion, it is more common in patients with a history of repeated concussions. In this case your child needs regular follow-up by a doctor.
For my daughter, it took her more than a week for her fatigue and repeated headaches to resolve. Since then she is back to testing her limits again!
Dr Peter Chiu is based at Raffles Hotel Arcade clinic. Dr Peter also speaks German. To make an appointment please call +65 6332 2727