Most head injuries in children are relatively minor and are seldom severe enough to justify the hours that parents spend worrying about them. There are a variety of signs and symptoms to watch for following a head injury during the first 24 to 48 hours. Some of these symptoms are common following a head injury and are only worrisome if they become excessive. You should observe your child for the following symptoms and report them to the doctor as instructed.
- If your child loses consciousness, you should immediately contact the physician.
- Drowsiness. Most children will become drowsy after a head injury and sleep. It does no harm for your child to fall asleep. In fact, this is very common. It is important, however, to make sure that your child can be fully aroused. It is a good idea to awaken your child every three to four hours during the night after a bad blow to the head. If you have difficulty in waking your child, you should report this to the doctor. You should observe your child for the following symptoms and report them to the doctor as instructed.
- Any convulsion or seizure following head trauma should be reported to the doctor.
- Double vision or other visual problems should be reported to the doctor.
- Unequal pupils should be reported to the doctor.
- Weakness in one arm or one leg should be reported to the doctor. Any limp or staggering which persists more than a few minutes after the head injury should be reported.
- Any abnormal leakage of fluid from the nose or ears should be reported to the doctor.
- Vomiting. Vomiting is common following even minor head trauma. If it persists more than twice following head trauma, you should report this to the doctor.
- If your child develops slurred speech or is unable to speak, you should contact the doctor.
- Headache. This is a common symptom after head injury. If it persists or becomes increasingly severe despite acetaminophen (Tylenol – see Dosing Guide), you should notify the doctor.
- Mental Status. If your child just seems to be “not with it” or not acting normal, you should contact the doctor.
- Significant head injuries in infants, such as falls from height as in a parent holding the child while falling, should be immediately evaluated by a physician despite having no symptoms.
If your child exhibits none of the above, then it is very unlikely that your child has sustained a significant head injury. A hematoma (a collection of blood under the skin at the site of head trauma) or “goose egg,” as some parents call them, is of no consequence unless it is huge (size of a baseball). This will resolve on its own. In addition to the guidelines outlined above, please see our section on concussion on this website.