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 it may result in bleeding or bruising of the brain.
External (Scalp) Injuries
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 a week 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
difficult to awaken
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 every 3 to 4 hours. If you use ice, always wrap it in a washcloth or sock; ice applied directly to bare skin can cause cold injury to the skin.
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 once or twice to also check for 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 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.
Suspected Internal Injury
The brain is cushioned by cerebrospinal fluid, but a severe blow to the head may knock the brain into the side of the skull or tear blood vessels. Some internal head injuries — complications of a fractured skull, torn blood vessels, or damage to the brain itself — can be serious and possibly life threatening.
Different levels of injury require different levels of concern. It can be difficult to determine the level of injury, so it's always wise to discuss a head injury with your doctor.
What to Look for and What to Do
Call 911 if your child shows any of these symptoms after a head injury:
unconsciousness for more than a few minutes
obvious serious wound
bleeding or clear fluid from the nose, ear, or mouth
Do not try to move your child in case there is a neck or spine injury.
Call for help.
Turn a child who is vomiting or having a seizure onto his or her side while trying to keep the head and neck straight. This will help prevent choking and provide protection in case of neck and spine injury.
If your child is conscious:
Do your best to keep your child calm and still.
If there's bleeding, apply a clean or sterile bandage.
Do not attempt to cleanse the wound, which may aggravate bleeding and/or cause serious complications if the skull is fractured.
Do not apply direct pressure to the wound if you suspect the skull is fractured.
Do not remove any object that's stuck in the wound.
Concussions are also a type of internal head injury. A concussion is the temporary loss of normal brain function due to an injury. Repeated concussions can result in permanent injury to the brain. However, it's possible to get a concussion that's mild and doesn't result in long-term damage.
One of the most common reasons kids get concussions is through sports, so make sure yours wear appropriate protective gear and don't let them continue to play if they've had a head injury.
If your child sustains an injury to the head, watch for these signs of a possible concussion:
"seeing stars" and feeling dazed, dizzy, or lightheaded
memory loss, such as trouble remembering what happened right before and after the injury
blurred vision and sensitivity to light
slurred speech or saying things that don't make sense
difficulty concentrating, thinking, or making decisions
difficulty with coordination or balance (such as being unable to catch a ball or other easy tasks)
feeling anxious or irritable for no apparent reason
If you suspect a concussion, call your doctor for further instructions.
Preventing Head Injuries
It's impossible to prevent kids from ever being injured, but there are ways to help prevent head blows.
your kids always wear appropriate headgear and safety equipment when biking, in-line skating, skateboarding, snowboarding or skiing, and playing contact sports. Wearing an appropriately fitting bike helmet, for instance, reduces the risk of head injury by about 85%.
your child takes it easy after a head injury, especially if there is a concussion
your child doesn't go back to rough play or playing sports until the doctor gives approval. (If your child reinjures the brain while it's still healing, it will take even more time to completely heal.)
Most kids stumble and fall from time to time, but a child who continually loses his or her balance might have a balance disorder.
The term concussion conjures up the image of a child knocked unconscious while playing sports. But concussions can happen with any head injury, often without any loss of consciousness.
In a concussion, the brain shifts inside the skull. This can cause a sudden - but usually temporary - disruption in a person's ability to function properly and feel well.
Ow! You fell and hit your head. But do you have a concussion? Find out about concussions in this article for kids.
Dealing With Falls
Falls are mostly a problem for young children and old people, but they can happen to active teens. Find out what to do - and when to get medical attention - by reading this printable instruction sheet.
Dealing With Sports Injuries
You practiced hard and made sure you wore protective gear, but you still got hurt. Read this article to find out how to take care of sports injuries - and how to avoid getting them.
Falls Instruction Sheet
Although most result in mild bumps and bruises, some falls can cause serious injuries that require immediate medical attention.
Getting Help: Know the Numbers
The best time to prepare for an emergency is before one happens. Make sure your family knows emergency phone numbers - and make sure your kids know how to place a call for help.
Knowing Your Child's Medical History
In an emergency, health care professionals will have many questions about a patient's medical history. It's easy to compile this information now, and it could save critical minutes later.
Preventing Children's Sports Injuries
Participation in sports can teach kids sportsmanship and discipline. But sports also carry the potential for injury. Here's how to protect your kids.
Safety Tips: Inline Skating
Inline skating is good exercise and an excellent off-season training program for hockey and skiing. To stay safe while inline skating, take a look at these tips.
Safety Tips: Skateboarding
Skateboarding is undeniably cool, but it's also easy to get hurt. Keep it safe while skateboarding with these safety tips.
Safety Tips: Sledding
Sledding is a lot of fun, but can also cause injuries, some of them pretty serious. To keep yourself safe while sledding, follow these safety tips.
Stay Safe: Baseball
Attention, baseball players: Getting hurt stinks, so check out these 10 tips for staying safe when you're on the diamond.
American Academy of Pediatrics (AAP)
The AAP is committed to the health and well-being of infants, adolescents, and young adults. The website offers news articles and tips on health for families.