Head injuries are common in children and often are a source of significant concern for parents. You should always take your child to the Emergency Department if the head injury involved any of the following:
● Loss of consciousness
● Seizure
● A persistent state of confusion or amnesia
● Slurred speech
● Multiple episodes of vomiting lasting more than 15 minutes
● Muscle Weakness/difficulty walking or moving
● A laceration that needs stitches (gaping wound, significant bleeding that won’t stop after 10
minutes of pressure)
● A depression in the skull
● Inconsolability for more than 15 minutes
The majority of head injuries are “low risk” and can be managed at home with careful observation. Many children will have an episode or two of vomiting shortly after a head injury — this is normal. If there are multiple episodes of vomiting that go on for more than 15 minutes, it is best to be evaluated by a physician. We would also like to evaluate after a head injury if a child seems excessively sleepy at a time when you wouldn’t expect him/her to be or if he/she is not acting like him/herself (inconsolable, irritable, slow to respond, etc.). After a head injury it is quite common to note significant swelling on the head. This is normal and is not cause for concern unless there is a depression in the skull. If you notice swelling or bruising on other areas of the body such as a limb, it may be necessary to be evaluated, or to discuss an X-Ray with your doctor. For children who do not have any of the issues noted above (reasons to go the the ED), it is okay to watch them at home. Watch for any of the bulleted symptoms described above. If the head injury occurred close to nap or bedtime, you can let your child sleep once you have established that he/she is back to acting like him/herself.
