How to Handle Head Injuries

The Injury

How Head Injuries Happen

Young kids are the most likely to hurt their head -- and for good reason: They have lots of falls in the tub, and they're less sure on their feet as they're starting to walk. They're testing their limits too. Tricia Honea, of Issaquah, Washington, learned this not long ago. Her 5-year-old son, Atticus, was hanging on a railing at Disneyland's California Adventure, despite her requests for him to stop. "Then he flipped upside down and lost his grip," Honea explains. "He hit his head on one of the decorative rocks and there was blood everywhere."

Most kids' head injuries happen in an instant. Children will roll off a changing table, tumble down stairs, run into each other on the playground because they weren't watching where they were going, or fall off their bike or an ATV (which they shouldn't be riding until they're at least 16, says the American Academy of Pediatrics).

These days, doctors are increasingly concerned about a condition called second-impact syndrome. Research has shown that if a child bumps her head again before a first injury has healed, the second injury can have a more lasting effect. In rare cases, second-impact syndrome can be fatal.

What to Look For

As soon as the accident occurs, and up to a few weeks after, it's crucial to watch for confused speech, lethargy, blurred or double vision, difficulty with balance or walking, vomiting, headaches, and pupils that are bigger than normal or of unequal sizes. Ask your child whether he feels nauseous, has trouble tasting or smelling, or hears a ringing in his ears.

With babies who aren't yet walking or talking, danger signs include bulges at the fontanelles (the soft spots on the front and back of the skull), vomiting, lethargy, difficulty feeding, and high-pitched crying. Head injuries can even leave a dent in the skull. If you notice any of these symptoms, call your pediatrician. Of course, head straight to the emergency room should your child lose consciousness, advises Avinash Mohan, M.D., co-chief of pediatric neurosurgery at Maria Fareri Children's Hospital at Westchester Medical Center, in Valhalla, New York.

That's what Atticus Honea's parents did. Once at the local hospital, they struggled to keep the 5-year-old awake. If they had let him fall asleep, doctors would not have been able to tell whether he was sleeping or whether he'd lost consciousness. In the end, the doctors stapled a flap of skin on Atticus's head and concluded that he had not suffered a concussion because he wasn't losing consciousness; he was just tired. Fortunately, the gash on his head was not a sign of anything serious. There are a lot of blood vessels in the face and scalp, which is why head wounds often bleed so heavily, explains Dr. Mohan.

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