Head Injuries and Falls

No matter how careful we try to be, inevitably accidents and injuries happen. Fortunately, most head injuries and falls in infants and children are minor and do not require emergency intervention.

As one would expect, the more serious the accident, the more likely the child is to sustain significant injury. For example, an infant who falls off a bed onto a carpeted surface is very unlikely to sustain significant injury. The majorities of falls in children occur from heights of 3-4 feet or less, and generally do not result in significant injury.

When to worry about a head injury in your child

1. Loss of consciousness
2. Vomiting
3. Seizures
4. Excessive sleepiness
5. Excessive irritability
6. Any abnormality in your child's neurological functioning: This includes any weakness, clumsiness, or changes in personality, or asymmetry of movement or facial expression.
7. Amnesia in older children: This includes amnesia for the event or short term memory loss occurring after the event.

If your child has any of the above symptoms after a head injury, you should take your child to the emergency room or call our office.

The doctor at the emergency room will evaluate your child and likely order a CT (cat scan) of the head. The CT is necessary to evaluate for any bleeding in the brain. If the CT is negative, then it is generally safe to discharge the child home under parental observation.

In children with mild head injuries with no loss of consciousness, normal alertness, no history of vomiting, seizures, or amnesia, the risk of serious pathology requiring medical or surgical intervention is much less than 1%.

If your child does not have any of the above warning signs, then you can safely observe your child at home. Some experts think that if there are no warning signs, you can safely let your child sleep through the night. Other experts recommend awakening your child several times throughout the night to reassure yourself that he is easily aroused and clearly recognizes you. Depending on how hard your child hit his head, you may want to wake your child every four hours throughout the first night after injury, especially if the injury happened close to bedtime and you were unable to observe your child awake for several hours.