Kids Health Info

Head injury - general advice

  • Children have many bangs to the head and it can be difficult to tell whether they are serious or not. If your child has received an injury to the head, you should see a doctor.
    Any knock to the head that causes lumps, bruises, cuts or more severe injuries is a head injury. Many head injuries are not serious and simply result on a bump or bruise. Occasionally, head injuries can result in damage to the brain.

    Seek medical help immediately if:

    • Your child has had a hard bang to the head, such as falling off something high or from a car accident.
    • Your child losses consciousness (passes out).
    • Your child seems unwell and vomits several times after hitting their head.

    Signs and symptoms

    The symptoms of head injuries are used to determine how serious the injury is. Head injuries can be classified as minor, moderate or serious.

    A severe head injury is when your child:

    • Has lost consciousness for more than 30 seconds.
    • Is drowsy and does not respond to your voice.
    • Has other significant head injury signs, such as unequal pupils, arm and leg weakness.
    • Has something stuck in their head.
    • Has a second fit or convulsion, other than a single brief one when the injury happened.

    You should call an ambulance immediately if your child has a severe head injury.

    A moderate head injury is when your child:

    • Has lost consciousness for less than 30 seconds.
    • Is alert and responds to your voice.
    • Has vomited two times or more.
    • Has a headache.
    • One brief fit may have happened straight after the injury.
    • May have a large bruise, lump or cut on the head.

    Your child should be watched closely in hospital for at least four hours after a moderate head injury.

    A minor head injury is when your child:

    • Has not lost consciousness.
    • Is alert or interacts with you.
    • May have vomited, but only once.
    • May have bruising or cuts on their head.
    • Is otherwise normal.

    Treatment of a minor head injury

    Most children with minor head injuries make a full recovery. Most small knocks just cause bruising and pain for a short while.

    • Apply ice or a cool wash to the injured area to help reduce the swelling.
    • If your child has a cut, apply a clean dressing and press on it for about five minutes. Cuts to the head will often bleed a lot.

    Problems to watch for in the next day or two:

    • Headache. Your child may have a headache. Give paracetamol every four to six hours if needed to relieve pain.
    • Vomiting. Your child may have vomited once but if vomiting continues, go back to your doctor or nearest hospital emergency department. 
    • Drowsiness. Immediately after the head injury your child may be sleepy.  There is no need to keep your child awake if they want to sleep. If your child does go to sleep, wake them every half to one hour to check their condition and their reactions to familiar things. You should do this until they are no longer drowsy and have been awake and alert for a few hours.  Some questions you could ask are:  
       Do they know where they are?
      Do they know familiar people's names?
      Do they know which day it is?
      Or if they are very young:
      Do their reactions seem appropriate? e.g. reaching out for a dummy. 
      Are they interactive and not too irritable?

    If you have any difficulty waking your child, take them to the nearest emergency department or call an ambulance.

    If your child's behaviour is very different to their normal behaviour, or the pain does not go away, go back to your doctor or nearest hospital emergency department.  

    Follow up

    Some problems that may result from a minor head injury can be hard to detect at first. In the next few weeks parents or carers may notice:

    • irritability;
    • mood swings; 
    • tiredness;
    • concentration problems;
    • behavioural changes.

    Talk to your doctor if you are worried about any of these signs.

    Go back to your doctor or hospital immediately if your child has:

    • Unusual or confused behaviour. 
    • Severe or persistent headaches which are not relieved by paracetamol (might be seen as irritability in a baby). 
    • Frequent vomiting. 
    • Bleeding or discharge from the ear or nose. 
    • A fit or convulsion, or spasm of the face or arms or legs. 
    • Difficulty in waking up. 
    • Difficulty in staying awake. 
    • Or if you are worried for any reason.

    Key points to remember

    • If your child has received an injury to the head, you should take them to see a doctor.
    • Apply ice or a cool wash to the area injured to help reduce the swelling.

    Other sources of information

    Developed in consultation with The Royal Children's Hospital Neurosurgery and General Medicine.  First published 2003. Reviewed June 2006.

Disclaimer
This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital, Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts.