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HEAD INJURY

DESCRIPTION

A head injury can occur with or without unconsciousness or other visible signs.
Appropriate health care includes:
  • Home care.
  • Physician's monitoring of general condition and medications.
  • Hospitalization for observation, if signs and symptoms are severe.

    SIGNS & SYMPTOMS
    Depends on the extent of your child's injury. The presence or absence of swelling at the injury site is not related to the seriousness of the injury. See also Head Injury, Skull Fracture in Illnesses section. Signs and symptoms include any or all of the following:

  • Drowsiness or confusion.
  • Vomiting and nausea.
  • Blurred vision.
  • Pupils of different size.
  • Loss of consciousness--either temporarily or for long periods.
  • Amnesia or memory lapses.
  • Irritability.
  • Headache.
  • Bleeding of the child's scalp, if the skin is broken.

    CAUSES
    Injury. The worst injuries usually result from motor-vehicle accidents.

    RISK FACTORS

  • Contact sports, especially football or boxing.
  • Seizure disorders.
  • Excess alcohol consumption.

    PREVENTING COMPLICATIONS OR RECURRENCE

  • Urge your child not to drink or use mind-altering drugs and drive.
  • Encourage your child to wear protective headgear for contact sports and cycling.
  • Use your auto seat belt or shoulder harness and encourage everyone in the family to do the same. Place young children in safety car seats.

    BASIC INFORMATION

    MEDICAL TESTS

  • Your own observation of symptoms.
  • Medical history and physical exam by a doctor.
  • Laboratory studies of your child's blood and cerebrospinal fluid.
  • X-rays of the child's skull and neck.
  • CAT or CT Scan (computerized axial tomography) of the head: Non-invasive computerized X-ray images that show sections (or "slices") of an organ or region of the body clearly and precisely (See Glossary).

    POSSIBLE COMPLICATIONS

  • Bleeding under the skull (subdural hemorrhage and hematoma).
  • Bleeding into the brain.

    PROBABLE OUTCOME
    Usually curable with early recognition of danger signs and medical treatment. Complications can be life-threatening to your child or cause permanent disability.

    TREATMENT

    HOME CARE

  • The extent of injury can be determined only with careful examination and observation. After a doctor's examination, your injured child may be sent home--but a responsible person must stay and watch the child for serious symptoms. The first 24 hours after injury are critical, although serious aftereffects can appear later.
  • If you are watching the patient, it is important to awaken the child every hour for 24 hours. Report to the doctor immediately if you can't awaken or arouse the child. Report also any of the following: -- Vomiting. -- Inability to move arms and legs equally well on both sides. -- Temperature above 100F (37.8C). -- Stiff neck. -- Pupils of unequal size or shape. -- Convulsions. -- Noticeable restlessness. -- Severe headache that persists longer than 4 hours after injury. -- Confusion.

    MEDICATION

  • Don't give any medicine--including non-prescription acetaminophen or aspirin--until the diagnosis is certain.
  • See Medications section for information regarding medicines your doctor may prescribe.

    ACTIVITY
    Your child should rest in bed until the doctor determines the danger is over. Normal activity may then be resumed as symptoms improve.

    DIET & FLUIDS
    Full liquid diet for the child until the danger passes.

    OK TO GO TO SCHOOL?

    When appetite has returned and alertness, strength, and feeling of well-being will allow.

    CALL YOUR DOCTOR IF

    Your child has symptoms of a head injury or you observe them in someone else.

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