By Bjarne Lühr Hansen PhD, MD and Philipp Skafte-Holm MD, Mentor Institute
All hits to the head can be dangerous. Concussion and a haematoma in the head are the most serious consequences. Concussion appears as unconsciousness, memory loss, nausea, vomiting and headache. A haematoma in the head develops a few hours after the child struck its head. Signs of a haematoma are drowsiness, vomiting or increasingly strong headache. All children with a concussion or suspicion of a haematoma in the head must be examined by a doctor immediately.
Most parents have experienced that their child hurts its head. The startle and the anxiety for the child’s injury are normal reactions. The smallest children most often hit their head when falling from small heights like bed, chair or pram, while larger children hit their head in connection with traffic accidents, sports or violent play.
All hits to the head can be dangerous but are not necessarily. When they child has hit its head it is important to ask the two following questions:
- does the child have a concussion?
- does the child have a haematoma in the head?
Does the child have a concussion?
Concussion arises when the brain is violently shaken. Concussion appears as brief unconsciousness, headache and memory loss. Nausea and vomiting are other signs of concussion. A concussion can be light or severe and usually requires the child is examined by a doctor.
Since the child’s age is of great importance to how parents should handle a concussion, we have chosen to split ‘concussion’ into two sections – one for children less than 5 years old and one for children more than 5 years old.
Children less than 5 years old:
It is particularly difficult to determine how serious the situation is with smaller children. Information about how much the child has hit its head often lack or are unsure – the child cannot tell you yourself. Meanwhile, it is established that there is no clear connection between how hard you hit the head and the damage caused by the blow. A fall from the second or third floor does not necessarily cause heavy damage, while a fall from, for example a chair can cause heavy damage.
No concussion: If the blow to the head is very weak and the child reacts with brief crying and, thereafter, normal behaviour. This means that the child smiles, drinks and reacts to touch and sounds as usual.
Light concussion: The blow to the head leads to brief unconsciousness and often, the child reacts with violent crying and unrest. Hereafter, the child becomes quiet, pale, weak, possibly vomits and becomes drowsy.
Severe concussion: The blow to the head leads to prolonged unconsciousness – this means that the child does not scream or cry immediately following the blow. Hereafter, the child becomes quiet, drowsy and vomits.
Children more than 5 years old:
With children more than 5 years old, it is easier for the parents to evaluate the situation. Information regarding whether the child has been unconscious and the following observation of the child is easier because the parents can talk to the child.
No concussion: In far the most cases, the child reacts with fright and crying but immediately after continues to play. The child behaves normally and does not complain about nausea or headache.
Light concussion: The child is unconscious for a few seconds just after the blow to the head. Brief memory loss and confusion may occur immediately after the incident. The child complains about headache, nausea and vomiting may occur.
Severe concussion: The child is unconscious for a longer period just like the memory loss will be for a longer period.
Does the child have a haematoma in the head?
A blow to the head can cause blood vessels beneath the scull to tear and a haematoma is formed inside the head of the child. You can tell whether it is a haematoma, if the child, a few hours after the blow, complains about increasing headache, weakness and difficulty keeping balance. The child starts to vomit and becomes drowsy.
A haematoma inside the head can arise at any time during the first 24 hours after the blow to the head has occurred. This is why parents must keep an eye on their child 24 hours after it has hit its head. A haematoma inside the head is a fatal condition, if the doctors do not drill a hole to empty the haematoma, in time.