How to Care for Your Child with a Head Injury or Concussion

This leaflet will provide you with information about head injury and concussion causes, symptoms, diagnosis, treatment, and home care advice.

Head injury in children is common. Most head injuries are not serious

Head injuries are classified as:

Head injuries are commonly caused by:

A concussion is a term of a mild form of traumatic brain injury and is common in children during sports activities.

Scalp swelling: this is common because the scalp has many small blood vessels that can bleed.
Loss of consciousness: usually just for a brief period of less than one minute
Headache: This may be in the form of irritability (bad temper) or other discomforts in children who are too young to speak.
Vomiting: Children who vomit after a head injury do not necessarily have a serious brain injury unless vomiting is repeated
Seizure: Not all children who have a seizure will have a serious head injury

Common symptoms of a concussion include:

Headache
Mild confusion
Nausea (feeling sick) or vomiting
Dizziness
Fatigue and tiredness
Inability to concentrate
sudden changes in behavior
bothered by bright light or loud noises
Disturbance of sleep pattern
Amnesia (temporary memory loss, not being able to remember events around the time of the injury)

The doctor will ask a few questions about your child's health and examine your child to determine the seriousness of the injury.
The doctor will advise you if further investigations are required
Most children with concussion do not need x-rays, CT-scan or MRI
Even with a normal brain CT or MRI, your child can still have a concussion

Your child's doctor will decide the suitable treatment based on the clinical assessment, the seriousness of the injury and the outcome of the observation period.
Most of the time, a period of watching the child for 4-6 hours is all that is needed. If your child develops any symptoms of concerns during this period, then the doctor will decide about further testing and imaging.
Children are at very low risk of having serious brain injury if they remain well more than 12 hours after the head injury.

Most children with a minor head injury can be safely watched at home; here are a few things that you can do at home to help your child

A mild headache, dizziness, and nausea are common, especially during the first 48 hours after the injury.
Make sure your child is cared for by a responsible adult for at least 48 hours.

Pain relief medicine:

Your child may have a headache or soreness around the injured area. You can give your child:
- Paracetamol (any brand) or Ibuprofen (any brand)
- Follow the instruction on the medicine package for the correct dose for your child
- Do not give your child Aspirin as this can cause serious complications

Feeding:

If the child is nauseous or has vomited once, try offering clear liquids such as soft drinks, clear juice

Rest

Encourage your child to lie down or choose a quiet activity.
Your child can sleep. It is not dangerous to sleep after a minor head injury. Sleep is an important part of the brain’s recovery from a concussion and will help your child to feel better.
It is not usually necessary to wake your child from sleep after a minor head injury.
If your doctor recommends waking the child, he or she should be able to wake up and recognize his/ her surroundings and parent/caretaker
Avoid television, mobile phones, tablets, or computer games until your child is symptoms free.

Bleeding

If there is a skin wound:

Apply pressure to the bleeding area with a clean cloth do not put coffee or any other household material in the wound
Bleeding should stop within 10 minutes.

Swelling

Swelling (a large lump or "goose egg") is also common after a head injury this is because the scalp is rich with blood supply.
To reduce the swelling, you can apply ice or a cold pack to the area for 20 minutes.
The swelling may take up to one week to completely disappear

Return to play

A serious brain injury may occur if your child has a second head injury within a short time after the first injury.
Please confirm with your doctor if your child can return to active play or sports.
If your child had concussion, do not allow your child to return to exercise until their symptoms have been reevaluated by a healthcare professional

You should go to the emergency department if your child: