Head injuries are a very common ‘urgent fit-in’ at our practice. They run the gamut from minor scratches and bumps to injuries causing permanent brain injury. In children even minor head injuries can have quite significant consequences, and so all head injuries are best assessed by a doctor – either a GP if the injury is minor (e.g. without loss of consciousness), or at an emergency department if moderate to severe (for injuries with a change in consciousness, motor vehicle accidents, fall from heights etc.).
Red flags that indicate a very severe injury has occurred include the child being ‘knocked out’ or disorientated, any twitching or seizures, vomiting more than once, trouble speaking or weakness. If you note any of these symptoms (including in the weeks after the injury) you should phone for an ambulance immediately.
Even relatively minor injuries can result in weeks of sub-par concentration and energy, headaches and irritability and it is very important to allow any child suffering a head injury time to recover completely. Younger patients require relatively longer to recover, sometimes up to 6 weeks even for quite minor injuries. The CDC has a great guide to graded return to usual activities on their page: http://www.cdc.gov/headsup/providers/return_to_activities.html which is consistent with current best practice in Australia. It is important to limit the exposure of the child to a second head injury during the recovery period, and so this may mean placing strict limitations on more physical sports.
Also don’t forget it is best to avoid the head injury in the first place – enforce wearing helmets appropriately, and control activities where head injuries are commonplace – eg heading a soccer ball, or tackle footy in young kids.
Dr Cath Hester
These articles are not intended to replace a one-to-one relationship with a qualified health professional or as specific medical advice. They are intended as a sharing of knowledge and information from experience and research in the scientific literature. I encourage you to make your own health care decisions based upon a partnership with a qualified health care professional.