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					| Head Injury, Age 3 and Younger
		
			| Head Injury, Age 3 and YoungerSkip to the navigationTopic OverviewHead injuryAlmost all children will bump their heads, especially when they are
		babies or toddlers and are just learning to roll over, crawl, or walk. These
		accidents may upset you, but your anxiety is usually worse than the injury.
		Most head injuries in children are minor. Head injury occurs more
		often in young children than adults. When compared with adults: Young children can't control the movement of
		  their heads as well as adults. 
		  Their heads are larger in relation to their
				bodies.Their neck muscles are not as well developed.
Young children's legs are somewhat shorter in
		  proportion to the rest of their bodies. This makes a child's center of gravity
		  closer to the head than an adult's center of gravity.Young
		  children are more likely to have an accident or fall as they learn new skills
		  such as walking, running, and jumping.
 Bumps, cuts, and scrapes on the head and face usually heal
		well and can be treated the same as injuries to other parts of the body. A
		superficial cut on the head often bleeds heavily because the face and scalp
		have many blood vessels close to the surface of the skin. This bleeding is
		alarming, but often the injury is not severe and you can stop the bleeding with
		home treatment. When bleeding does not stop with home treatment, visit
		a doctor because a young child can lose a large amount of blood from a deep cut
		on the head. The most common serious head injuries in young
		children are caused by falls and abuse (inflicted head injuries), such as shaken baby syndrome. Serious head
		injuries may involve injuries to the brain. The more force that is involved in
		a head injury, the more likely it is that a serious injury to the brain has
		occurred. If there has been a
		high-energy injury to the head, there is a greater
		likelihood that a serious injury has occurred. When a high-energy injury
		occurs, it is even more important to assess the child for
		signs of a serious head injury.  Following an injury, it can be hard to tell the difference between a
		mild traumatic brain injury (concussion) and a more serious brain
		injury. Watch the child carefully for 24 hours after a head injury to see
		whether he or she develops any signs of a serious head injury.  When a head injury has occurred, look for injuries to other parts of the
		body. The alarm of seeing a head injury may cause you to overlook other
		injuries that need attention. Trouble breathing, shock, spinal injuries, and  severe bleeding are all life-threatening injuries that may occur along with a
		head injury and require immediate medical attention.
		Injuries to the spine, especially the neck, must be
		considered when a head injury has occurred. Be sure to check for other injuries to the face, mouth, or teeth whenever there is a head injury. Many head injuries can
		be prevented. Use car seats, seat belts, helmets, and
		make your home safe from falls to prevent an injury. Establish good safety
		habits early so your child will continue them when he or she is older.  Check your child's symptoms to decide if and when your child
		should see a doctor.Check Your SymptomsHas your child had a head injury?How old are you?  Less than 4 years Less than 4 years4 years or older 4 years or olderIs the wound bleeding? If you think the wound may need stitches, it's best to get them within 8 hours of the injury.Do you think there could be a spinal cord injury ?Yes Possible spinal cord injuryNo Possible spinal cord injuryThese could appear at the time of the injury or later. Yes Symptoms of serious head injuryNo Symptoms of serious head injuryDid a seizure occur after the head injury? Yes Seizure after head injuryNo Seizure after head injuryDid the seizure occur within the past 2 days (48 hours)? Yes Seizure occurred within past 2 daysNo Seizure occurred within past 2 daysIs there a wound that goes through the skull, such as a knife or gunshot wound?Yes Symptoms of skull fractureNo Symptoms of skull fractureIs there swelling anywhere on the head? Swelling in certain areas of the head can be a sign of a skull fracture.Is the only swelling a bump or "goose egg" on the forehead? Swelling in any other area of the head, such as the temple area or the side or back of the head, could be more serious. Yes Only swelling is bump or goose egg on foreheadNo Only swelling is bump or goose egg on foreheadDid your child pass out (lose consciousness) after the injury? Yes Lost consciousness after injuryNo Lost consciousness after injuryWhen did your child pass out? Within the past 24 hours Loss of consciousness within past 24 hoursMore than 24 hours (1 full day) after the injury Loss of consciousness more than 24 hours agoWas there a lot of force involved in the head injury? Some examples are a fall onto the head from a height taller than the child, or a very hard blow to the head, such as in a car crash or a forceful sports injury. Yes A lot of force involved in head injuryNo A lot of force involved in head injuryWhen did the head injury occur? Less than 24 hours ago Injury occurred less than 24 hours agoFrom 1 full day (24 hours) to 1 week ago Injury occurred from 1 day to 1 week agoMore than 1 week ago Injury occurred more than 1 week agoHas your child vomited more than once since the injury? Yes Vomited more than once after injuryNo Vomited more than once after injuryDo you think that the head injury may have been caused by abuse? A head injury caused by abuse is serious at any age, but this is especially true for babies .Yes Injury may have been caused by abuseNo Injury may have been caused by abuseSome symptoms may appear days or even more than a week after a head injury.  Yes Other symptoms after head injuryNo Other symptoms after head injuryAre the symptoms: Getting worse? Symptoms are getting worseStaying about the same (not better or worse)? Symptoms are unchangedGetting better? Symptoms are improvingHas your child had symptoms for more than 2 weeks after the injury? Yes Symptoms for more than 2 weeks after injuryNo Symptoms for more than 2 weeks after injuryMany things can affect how your body responds to a symptom and what kind
	 of care you may need. These include: Your age. Babies and older
		adults tend to get sicker quicker.Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart
		disease, you may need to pay closer attention to certain symptoms and seek care
		sooner.Medicines you take. Certain
		medicines, herbal remedies, and supplements can cause symptoms or make them
		worse.Recent health events, such as surgery
		or injury. These kinds of events can cause symptoms afterwards or make them
		more serious.Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug
		use, sexual history, and travel. 
Try Home TreatmentYou have answered all the questions. Based on your answers, you may be
		able to take care of this problem at home. Try home treatment to relieve the
		  symptoms. Call your doctor if symptoms get worse or you have any
		  concerns (for example, if symptoms are not getting better as you would expect).
		  You may need care sooner.
With severe bleeding, any of these may
	 be true: Blood is pumping from the wound.The
		bleeding does not stop or slow down with pressure.Blood is quickly soaking through bandage after bandage.
 With moderate bleeding, any of these may
	 be true: The bleeding slows or stops with pressure but
		starts again if you remove the pressure.The blood may soak through
		a few bandages, but it is not fast or out of control.
 With mild bleeding, any of these may be
	 true: The bleeding stops on its own or with
		pressure.The bleeding stops or slows to an ooze or trickle after
		15 minutes of pressure. It may ooze or trickle for up to 45 minutes.
Other symptoms related to a head injury that may appear later include: Repeated episodes of feeling dizzy or
		lightheaded.Changes in mood or personality. For a baby or toddler,
		you may notice this as the child being a lot fussier than
		normal.Changes in the ability to concentrate and listen.
		Ringing in the ears.
Symptoms of a spinal cord injury in a
	 child may include: Severe neck or back pain.Being unable
		to move part of the body.
Shock is a life-threatening condition that may occur quickly
	 after a sudden illness or injury.  Symptoms of shock in a child may include: Passing out (losing consciousness).Being very sleepy or hard
		to wake up. Not responding when being touched or talked to.
		Breathing much faster than usual. Acting confused.
		The child may not know where he or she is. 
Symptoms of a skull fracture may
	 include: Clear or bloody fluid draining from the ears or
		nose.Bruising under the eyes or behind the
		ears.Drooping of the face.A dent anywhere on the head.
Symptoms of a serious head injury may
	 include: Passing
		out.Becoming more and more drowsy, or hard to wake up.Cannot stop crying.A difference in the size of the pupils of the
		eyes.
Babies' heads are easily damaged, and their neck muscles are
	 not strong enough to control the movement of the head. Shaking or throwing a baby can cause the head to jerk back and forth. This can
	 make the skull hit the brain with force, causing brain damage, serious vision
	 problems, or even death.Seek Care NowBased on your answers, you may need care right away. The problem is likely to get worse without medical care.Call your doctor now to discuss the symptoms and
		  arrange for care.If you cannot reach your doctor or you don't have
		  one, seek care in the next hour.You do not need to call an
		  ambulance unless: 
		  You cannot travel safely either by driving
				yourself or by having someone else drive you.You are in an area
				where heavy traffic or other problems may slow you down.
Seek Care TodayBased on your answers, you may need care soon. The
		problem probably will not get better without medical care.Call your doctor today to discuss the symptoms
		  and arrange for care.If you cannot reach your doctor or you don't
		  have one, seek care today.If it is evening, watch the symptoms and
		  seek care in the morning.If the symptoms get worse, seek care
		  sooner.
Call  911  NowBased on your answers, you need
		emergency care. Call911or other emergency services now.Put direct, steady pressure on the
		wound until help arrives. Keep the area raised if you can.Call  911  NowBased on your answers, you need
		emergency care.Call911or other emergency services now.Do not move the person unless there is an immediate threat to the person's life, such as
		a fire. If you have to move the person, keep the head and neck supported and in
		a straight line at all times. If the person has had a diving accident and is
		still in the water, float the person face up in the water.Call  911  NowBased on your answers, you need
		emergency care.Call911or other emergency services now.Make an Appointment Based on your answers, the problem may not improve without medical
		care.Make an appointment to see your doctor in the
		  next 1 to 2 weeks.  If appropriate, try home treatment while you
		  are waiting for the appointment.If symptoms get worse or you have
		  any concerns, call your doctor. You may need care sooner.
Head Injury, Age 4 and OlderHome TreatmentFirst aid for a head injury Parents  should watch their child for any problems  after the injury. Home treatment can
		help relieve swelling and bruising of the skin or scalp and pain that occurs
		with a minor head injury.   If your child had an accident, try to remain
		  calm and speak to your child in a calm, relaxed voice. This will help reduce
		  your child's fear and allow you to assess the situation.To stop any  bleeding, apply firm pressure directly over the cut
		  with a clean cloth or bandage for 15 minutes. If the cut is deep and may have penetrated the skull,
		  emergency treatment is needed.Check for injuries to other parts of
		  the body, especially if the child has fallen. The alarm from seeing a head
		  injury may cause you to overlook other injuries that need
		  attention.Apply
		  ice or cold packs to reduce the swelling if your child will let you hold a cold pack on the injury. A "goose egg" lump may appear
		  anyway, but ice will help ease the pain. Always keep a cloth between your
		  child's skin and the ice pack. Do not apply ice for longer than 15 to 20
		  minutes at a time, and do not let your child fall asleep with the ice on his or
		  her skin. 
 If your child is seen by a doctorBe sure to follow
		  the instructions given to you by your child's doctor. He or she will tell you what problems to look for and how closely to watch your child for the next 24 hours or longer. Do not give any medicine, including
			 nonprescription
			 acetaminophen, such as Tylenol, to a child
			 you are watching for signs of a more serious head injury unless your doctor
			 tells you to. Symptoms to watch for during home treatmentCall your child's doctor if any of the following occur during home
		  treatment: New  headache develops or headache becomes worse.New nausea or vomiting develops or nausea or vomiting becomes worse.Crying does not stop.Drowsiness gets worse, or it is hard to wake up your child.Weakness develops in any part of the body.Confusion or not acting normally develops.Bleeding or swelling increases.Symptoms become more severe or more frequent.
PreventionPrevent head injuriesEach new learning stage for your baby
		requires increased attention on your part to prevent an injury. It may surprise
		you how fast your baby can move from one stage to the next. Being aware of your
		baby's abilities and what skills he or she is likely to develop next will help
		you prevent injuries. A nursery equipment safety checklist will help you keep your baby's environment safe. Always be gentle with your baby. Be sure to protect your baby from a brain injury.
		Shaking or slapping a baby in anger can cause an
		injury to the brain. If a baby has been shaken or slapped, it is your
		responsibility to notify your doctor. Be aware of your baby's risk
		of falling. Watch your baby carefully. Never leave your baby alone in high places, such
		  as on a tabletop, in a crib with the sides down, or even on a bed or
		  sofa.Do not leave your baby alone in any infant seat or "sitting"
		  toy, such as a swing or jumper. Use all the safety straps provided.
 Take steps to prevent falls: Use
		  stair gates to block stairways. Use gates at the top
		  and bottom of the stairs, and use the gates properly.Do not use
		  baby walkers. Walkers have caused many injuries and are not safe even if the
		  baby is watched closely.Keep your baby away from elevated porches,
		  decks, and landings.Watch your toddler when he or she is outside.
		  Uneven grass, sloping lawns, and hills may increase your toddler's risk of
		  falling.Make your home safe from falls by removing hazards
		  that might cause a fall.
 Practice good safety habits early so your child will continue
		them when he or she is older: Place children in an approved
		  child car seat when traveling in a motor vehicle.
		  Follow the manufacturer's directions for installing and securing the
		  seat.Have your children wear helmets whenever necessary, such as
		  when they are passengers on a bike or riding a tricycle on their
		  own.Set a good example by always using your seat belt when
		  traveling in a motor vehicle. Wear a helmet and other protective clothing
		  whenever you are biking, skateboarding, skiing, motorcycling, skating,
		  kayaking, horseback riding, or rock climbing.
 For more information on health and safety for children, see the topics Health and Safety, Age Birth to 2 Years or Health and Safety, Ages 2 to 5 Years.Preparing For Your AppointmentTo prepare for your appointment, see the topic Making the Most of Your Appointment. Questions to prepare for your appointmentYou can help your
		doctor diagnose and treat your child's condition by being prepared to answer
		the following questions: When and how did the injury
		  occur?How did your child act after the head
		  injury?Did your child cry immediately after the
		  injury?What are your child's main symptoms? How long has your
		  child had symptoms? Has your baby had a previous head injury? Does
		  your child have any continuing problems because of the previous injury?
		   What object caused the injury? Was there or is there an object in
		  a cut on the head? Was this injury intentionally caused by another
		  person?What home treatment measures have you used to treat the
		  head injury?If a cut or scape occurred, is your child's tetanus
		  immunization up-to-date?Was the use of alcohol or drugs by a
		  caregiver involved in your child's injury?Does your child have any
		  health risks?
CreditsByHealthwise StaffPrimary Medical ReviewerWilliam H. Blahd, Jr., MD, FACEP - Emergency Medicine
 Adam Husney, MD - Family Medicine
 Kathleen Romito, MD - Family Medicine
 Specialist Medical ReviewerKathleen Romito, MD - Family Medicine
Current as ofMarch 20, 2017Current as of:
                March 20, 2017 Last modified on: 8 September 2017  |  |  |  |  |  |