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A head injury is any kind of damage to the scalp, skull, brain, or other tissue and blood vessels in the head. A head injury is also often called a brain injury or traumatic brain injury (TBI), depending on the extent of the injury.
A head injury can be as mild as a bump, bruise (contusion), or cut on the head. Or it can be a concussion, a deep cut or open wound, broken skull bones, internal bleeding, or damage to the brain. Head injuries are one of the most common causes of disability and death in children.
Types of head injuries include:
This is an injury to the head that may cause instant loss of awareness or alertness for a few minutes up to a few hours. Some concussions are mild and brief, and you may not know that a concussion has occurred.
This is a bruise on the brain. A contusion causes bleeding and swelling inside of the brain around the area where the head was struck. In some cases a contusion may occur on the opposite side of the head because of the brain hitting the skull. This injury can happen from a direct blow to the head, violent shaking of a child, or a whiplash-type injury from a motor vehicle accident. The jarring of the brain against the sides of the skull can cause tearing of the internal lining, tissues, and blood vessels. It may cause internal bleeding, bruising, or swelling of the brain.
A skull fracture is a break in the skull bone. There are 4 major types of skull fractures:
There are many causes of head injury in children. Common causes are:
The risk of head injury is high in teens. Head injuries happen twice as often in boys than in girls. Head injuries are more common in the spring and summer months, when children are very active in outdoor activities such as riding bikes, roller skating, or skateboarding. Children who play sports such as football, soccer, hockey, and basketball are also at higher risk of concussion.
Symptoms can occur a bit differently in each child, and vary depending on how severe the injury is.
Symptoms of mild head injury may include:
Symptoms of moderate to severe head injury may include any of the above plus:
The symptoms of head injury can be like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.
The healthcare provider will ask about your child’s symptoms, health history, and recent injuries. He or she will give your child a physical exam. Your child may also have tests, such as:
Head injury can cause neurological problems and may need further medical follow up.
Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.
Treatment may include:
In some cases, a child may need to stay in the hospital. He or she may be watched more closely for problems. A child may also need:
A child may also need monitoring for increased pressure inside the skull. This is called intracranial pressure (ICP) monitoring. A head injury may cause the brain to swell. There is only a small amount of room for the brain to swell inside the skull. This causes pressure inside the skull to increase and can lead to brain damage.
ICP monitoring is done by placing inside the head. Intracranial pressure can be measured in 2 ways:
In both cases, the ICP device is inserted by the doctor either in the intensive care unit (ICU) or in the operating room. The ICP device is then attached to a monitor that gives a constant reading of the pressure inside the skull. If the pressure goes up, it can be treated right away. While the ICP device is in place, your child will be given medicine to stay comfortable. When the swelling has gone down and there is little chance of more swelling, the ICP device will be removed.
Talk with your child’s healthcare providers about the risks, benefits, and possible side effects of all treatments.
Children who suffer a severe brain injury may lose some function in muscle, speech, vision, hearing, or taste. This depends on the area of where the brain is damaged. Long- or short-term changes in personality or behavior may also occur. These children need lifelong medical and rehabilitative treatment. This may include physical, occupational, or speech therapy.
How well a child recovers from a head injury depends on the type of injury and other health problems that may be present. It is important to focus on maximizing your child's abilities at home and in the community. You can encourage your child to strengthen his or her self-esteem and have independence.
Head injury can be prevented in ways such as:
Call the healthcare provider if your child has:
Tips to help you get the most from a visit to your child’s healthcare provider:
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