Head Injury / Trauma

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The number one cause of death and acquired disability in the pediatric population is accidental trauma. It is estimated that head injury alone may account for the majority of these incidents.

Causes of Head Injury

Most pediatric head injuries are caused by a motor vehicle accident (MVA), fall, assault, sporting injury, or child abuse.

Signs/Symptoms

When a child experiences head trauma you can expect one or more of the following symptoms:

  • Tearing or bruising of the skin around the head (scalp injury)
  • Cracking/damage to the bone structure of the head (skull fracture)
  • Damage to the brain that changes the way it works (concussion)
  • Damage of brain tissue
  • Memory loss
  • Vomiting (emesis)
  • Sleepy, difficult to wake (loss of consciousness)
  • Bleeding inside the brain (intracranial hemorrhage)
  • Bleeding between the skull and the brain (subarachnoid hemorrhage)
  • Bleeding from the fluid filled areas of the brain (intraventricular hemorrhage)
  • Injury that penetrates the skull
  • Seizures

The damage may be centered in one area (focal) or spread out over a large area of the brain (diffuse). It is not uncommon to see changes/complications throughout the entire body after Traumatic Brain Injury.

What to do if you suspect your child has suffered head injury/trauma:

All parents/caregivers suspecting brain injury should seek out medical attention AS SOON AS POSSIBLE. Children suffering from head trauma can deteriorate quickly and it is often difficult to judge the level of injury by observation alone. This is why it is best to put your child in the hands of a trusted professional.

Diagnosis/Tests

In the event of suspected head injury your doctor may order a long list of tests, both to get an idea of your child’s overall health and help judge the extent of the damage. Commonly ordered blood tests may include:

  • Complete blood counts (CBC)
  • Blood chemistry
  • Blood clotting ability/factors (coagulation profile)
  • Blood type and cross match (Identifying the patient’s blood type)
  • Arterial blood gas.

A blood or urine drug test (toxicology) may also be ordered as certain medications and chemicals can cause a child to suffer from symptoms similar to head injury.

Along with blood tests, your doctor may order imaging (radiographic) studies to have a look at the actual tissues themselves. These often include:

  • Computed Tomography (CT) also known as a “Cat Scan” offers the doctor a quick look into the brain or other organs to determine if there has been tissue damage.
  • Magnetic Resonance Imaging (MRI) offers a more detailed image of the internal structures however, it typically takes longer to obtain.
  • Ultrasonography (Ultrasound, US) uses sound waves to generate an image of the structures inside the body and is very useful in diagnosing damage in newborns and infants whose skull plates (fontanels) have yet to close.

Managing Head Injury

After a head injury, it is the goal of your doctor to treat the life-threatening symptoms first then control any other symptoms that may arise. To do this your doctor may bring a specialist onboard such as a neurologist, neurosurgeon or epileptologist. A neurologist focuses on general study of the brain. A neurosurgeon is an expert on brain surgery. An epileptologist is a doctor whose focus is seizures.

These specialists can help your doctor better plan ways to manage any complications such as: seizures, internal bleeding, breathing /heart difficulty, inability to regulate temperature, pain control and issues requiring surgery.

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