Childhood head injury Dr Trisha Macnair Head injuries are common in children and, although most are minor, they can cause particular concern because of the risk of damage to very delicate and important areas.

In this article

What is head injury? Symptoms

Causes Treatment and Recovery

Further help

A head injury is any sort of accident or trauma that affects the head.

Cuts, tears or haemorrhages in the brain tissues and covering membranes can lead to a wide variety of problems, while fractures of the bones of the skull (including the face) can damage delicate tissues and increase pressure on the brain.

Other problems following head injury include damage to the spinal cord (head injuries often involve the neck, too), disruption of sight and hearing, as well as damage to the jaws and teeth, plus possible harm involving the major airways. Because all these important structures are found in the head, head injuries can take a huge toll. They can rapidly be life-threatening and are the major cause of long-term disability following an accident.

Symptoms include the visible effects of trauma to the head, such as a cut, bump or bruising. There may also be loss of consciousness (this may be brief), confusion, drowsiness, dizziness, headache, nausea and vomiting, blurred vision and loss of memory.

Straw-coloured or bloodstained fluid may be seen leaking from the child's nose or ears. This is cerebrospinal fluid, which normally bathes the brain, and is a sign of skull fracture requiring urgent medical attention.

Sometimes there are no (or minimal) immediate symptoms but the child collapses minutes or hours later, with a seizure or blackout. This may be caused for example when there is a slow haemorrhage beneath the skull which gradually puts pressure on the brain – this is known as a sub-dural haemorrhage and it needs urgent treatment.

Road traffic accidents are the most common causes of head injuries, especially when the child is a pedestrian or cyclist. Other common causes include falls from cots, windows or down stairs and sports injuries. Occasionally what seems to be a very small blow to the head, perhaps during some rough and tumble as kids play, leads to significant problems.

Get urgent medical advice if your child loses consciousness

You should get urgent medical advice if your child loses consciousness (even for a few moments), becomes drowsy, confused, vomits persistently, has seizures, has fluid coming from the ears or nose, or seems unwell. Sometimes a parent just feels instinctively that their child isn’t right – you should always listen to these instincts.

The child may need to be closely observed for 24 hours in hospital, where skull x-rays (to look for fractures), CT and MRI scans (to check for damage to or haemorrhage in the brain tissues) can easily be done. Surgery may be needed to repair damaged skin or bones, or to relieve pressure from bleeding inside the skull.

Most children are back to normal after a couple of days' rest, but symptoms can persist for a week or two. In severe injuries there may be long-term problems with learning difficulties, loss of muscle movement control, memory loss, personality changes - disruption of almost any aspect of the body controlled by the brain. Always get help if you are worried.

Organisations

Child Brain Injury Trust
Helpline: 0845 601 4939
Website: www.cbituk.org

Headway - The Brain Injury Association
Helpline: 0808 800 2244
Website: www.headway.org.uk

Brain Injury Rehabilitation Trust
Telephone: 01924 896 100
Website: www.birt.co.uk

Brain & Spine Foundation
Helpline: 0808 808 1000
Website: www.brainandspine.org.uk

This article was last medically reviewed by Dr Rob Hicks in February 2007