Head trauma

A head injury is a blow to the head that can vary in intensity (from a bump to a severe trauma).

Children are constantly hitting their heads or falling or, less frequently, being hit by a moving object.

Problems usually do not occur, but the child should be observed to make sure there are no complications.

Causes of head trauma

The causes are multiple. In babies, accidental falls from cribs, beds and changing tables are common. Falls are also common when they start to walk. In toddlers, collisions between peers (more in boys) are usually observed during play. The practice of sports affects school children and adolescents.

Traffic accidents (generally run over) are the other group of common causes of head trauma. Bicycle and motorcycle accidents affect mostly teenagers.

What symptoms appear?

The symptoms that appear after the blow are related to the intensity of the blow.

Fortunately, most of the time they are mild trauma with some drowsiness and a tendency to vomit.

Other times, there is what is called a concussion. Children may lose consciousness immediately after such an injury or go through a period of relatively normal behavior followed by problems. After head trauma, children may experience memory loss, be disoriented, or dizzy.

Visual disturbances, vomiting, nausea, headache or neck pain, or seizures may appear. In cases where there is brain damage (cranial contusion) the situation is more serious since loss of consciousness can lead to coma. Finally, skull fractures (which in babies are usually innocuous and with a good prognosis) and hemorrhages within the brain can be seen that require special care.

Diagnosis

The skull X-ray is the only thing that shows the existence of fractures in the bones of the head. You cannot see if the brain is damaged inside. This means that most of the time it is not very useful, since generally the existence or not of a fracture is not related to the severity of the picture. This would prevent many mildly injured babies from radiating without much justification.

The most important diagnostic test is observation and surveillance of the child in the first 48 hours after the trauma.

Depending on the symptoms the child has and the findings the doctor finds in the examination, the doctor will determine the performance of other tests, such as a CT or scan (which usually requires general anesthesia).

What to do when faced with a blow to the head?

• Make sure the child’s breathing is adequate and there are no other problems.
• Place a cool cloth at the point of impact to reduce swelling.
• Look for changes in your child’s behavior or wakefulness for at least one day after the accident.
• Check the child every 2 to 4 hours to see if he is improving.
• Keep monitoring your pupils (that is, the black circles in the center of your eyes are uneven in size), your level of awareness, and your ability to communicate. Wake him up as many times as necessary if he is not calm.
• Flush all cuts and scrapes with water after bleeding stops. Large or deep cuts may need stitches.
• Give pain relievers (aspirin, ibuprofen, or acetaminophen ) for pain. Do not give them very powerful medications because of the importance of observing the behavior and wakefulness of the child during the next day.
• Limit activities and eat a light diet.
• If there is neck pain, do not let your child move. Gently place your hands on either side of the child’s head until you can carefully place it on a board, and fix the head facing upward. Put padding material (such as towels or clothing) on ​​each side of the head to prevent movement.

Avoiding head injuries

Head injuries are very common in childhood due to a lesser sense of danger on the part of children, their natural mobility (it is said that they do not stop) and due to their lack of maturation in stability.

Children under three years of age have greater elasticity in the bones of the skull, which gives the brain a degree of protection. The circumstances of the accident are important.

The type of injury is determined by whether the accident was the result of a strong direct hit, a serious fall, or an accident involving a moving vehicle. To avoid the appearance of complications we must:

• In mild trauma, without loss of consciousness, observation in the child’s home is sufficient, observing changes in activity, consciousness or vision.
• Children with concussions should be monitored, preferably in a hospital.
• Those children with serious loss of consciousness should be admitted to an intensive care unit.