Head injuries in children are a serious problem that can have long-term consequences. Thousands of children suffer from head injuries every year, ranging from mild to severe. While some of these injuries are minor and heal quickly, others can have a lasting impact on a child’s physical and mental health. In this article, we will discuss the causes, symptoms, and diagnosis of head injuries in children, as well as the importance of prevention. We will also look at the long-term effects of head injuries. By understanding the risks and taking the necessary precautions, we can help ensure the safety and health of our children.
Don’t Underestimate Head Injuries in Children
Head injuries in children are quite common. Generally, they are minor and involve only the outer layers of the head, meaning there is no damage to the brain. However, there are cases of moderate and severe head injuries that require urgent medical attention. Every parent should know when it is necessary to call a doctor. Head injuries in children can involve the skin, subcutaneous tissue, muscles, and cranial bones, but also deeper structures such as blood vessels and the brain. It is possible for the outer layers to remain undamaged, but there could still be internal injuries. This is a very dangerous situation that should not be underestimated. It is important to monitor the child and if any worrying symptoms are observed, to call for help immediately.
The Alarming Reality of Head Injuries in Children
Research shows that in the UK, 5.6 out of 100,000 children aged 0 to 14 have head injuries. Road accidents are the most common cause of head injuries, occurring most often in children over 10 of age. (1) Children from lower socio-economic groups are more likely to suffer head injuries in pedestrian accidents. Children aged 0 to 10 are more prone to head injuries in the summer and in the afternoon. However, the most common cause of traumatic death in children under the age of 2, is head and brain injuries caused by ‘carers’.
In this age group, head injury is caused by Shaken Baby Syndrome (SBS), which is an alternative name to abusive head trauma (AHT). Head injury related to abuse often involves a strong blow or violent shaking that causes skull damage to an infant or young child. Complete recovery is possible, but serious brain damage and death can also occur (2).
Warning Signs and Symptoms of Brain Injury
Children with head injuries may experience a range of symptoms, from mild to severe. Those who have suffered a brain injury often show disorientation, nausea, vomiting, headaches, blurred vision, slurred speech, and behavioural abnormalities. A teenager may have seizures, lose consciousness, and have difficulty breathing in more severe cases. It is very important to be aware of the warning signs and symptoms of a brain injury, as if they are ignored, they can be life-threatening. It is necessary to seek medical help immediately if you think your child has suffered a brain injury (3).
Children who have suffered head injuries may sometimes develop many other symptoms in addition to those that elicit physically. Among many others, some examples include personality changes, post-traumatic amnesia, emotional expression disorders, changes in behaviour, apathy, depression, low energy, sudden mood changes, “childishness”, irritability, or temper. Psychosis, hallucinations, and delusions may also occur. In some cases, children may also experience difficulties with concentration, memory, and learning, as well as changes in day and night rhythm. Furthermore, some children may experience emotional and behavioural changes such as increased aggression, impulsiveness, and irritability (4).
Finally, it is important to remember that head injuries can be fatal and should never be taken lightly. It is very important to seek medical help immediately if you suspect that your child may have suffered a brain injury. Furthermore, you should visit A&E if you suspect someone has been deliberately harmed.
Head Injuries: When to Call for Emergency Help
If you suspect that your child may have suffered a brain injury, it is very important to provide them with prompt medical help as head injuries can be dangerous. Always do so if you observe any of the following symptoms: the child has lost consciousness, cannot fall asleep, has seizures, has fallen from a height, has problems with vision or hearing, has a black eye, there is clear fluid coming out of the ears or nose, bleeding from ears or bruises behind ears, numbness or weakness in a certain part of the body, problems with walking, balance, understanding, speaking or writing, head wound with a foreign body inside, or indentation on the head (3).
Head Injury Diagnosis
A neurological assessment of the patient and any further imaging tests are used to determine if any sequelae of the head injury have occurred. In the neurological assessment, it should be established if there are any symptoms of a disease that could have led to the injury (balance disorders, severe headache, consciousness disturbances) and if the injury occurred because of an accident (blow, fall). Ultrasonography (trans fontanelle ultrasonography) is usually used in new-borns, and computed tomography (CT) of the head in older children.
Preventing Head Injuries in Children
As head injuries are one of the most common causes of death and serious injury in children, the prevention of head injuries is a very important topic, and educating parents is of prime significance.
Children are very susceptible to head injuries, especially when they fall from heights, such as beds, changing tables or strollers. Parents should be aware of this fact. Therefore, in order to prevent such situations, children should always be supervised. Make sure that furniture is cushioned against sharp edges that could cause life-threatening head injuries.
Road safety is a key element in preventing brain injuries in adolescents. According to estimates, the probability of fatal and serious head injuries can be reduced by 45-55% by using airbags, seat belts and car seats. Parents should be educated on the benefits of child seats, seat belts and other road safety measures. The use of protective helmets when engaging in recreational and competitive sports is another important step in reducing head injuries in children. The use of a helmet can reduce the likelihood of fatal collisions and the severity of head injuries.
Head Injuries in Children: Need for First Aid Training
It is important that parents, guardians, and caregivers are aware of the objective and subjective symptoms of head injuries in children and are prepared to provide first aid if necessary. It is also important that all family members are trained in basic first aid and cardiopulmonary resuscitation. By taking the time to learn basic first aid, you can be prepared to provide your child with the best possible care in the event of a head injury.
Summary
Head injuries in children are a serious issue that can have long-term consequences. Every year, thousands of children suffer from head injuries, ranging from mild to severe. While some of these injuries are minor and heal quickly, others can have lasting effects on a child's physical and mental health. The most common causes of head injuries in children are road accidents, falls from heights, and abuse. It is important to be aware of the warning signs and symptoms of a brain injury, as if they are ignored, they can be life-threatening. Prevention is key, and parents should be educated on the benefits of child seats, seat belts, protective helmets, and other safety measures. It is also important that all family members are trained in basic first aid and cardiopulmonary resuscitation. By understanding the risks and taking the necessary precautions, we can help ensure that our children remain safe and healthy.
Bibliography
1) Parslow R C, Morris K P, Tasker R C, Forsyth R J, Hawley C A, Epidemiology of traumatic brain injury in children receiving intensive care in the UK, Arch Dis Child 90:1182–1187. 2005
2) Joyce T, Gossman W, Huecker M R, Pediatric Abusive Head Trauma, StatPearls Publishing. 2022 Jan.
updated on: 02.03.2023
updated on: 02.03.2023
4) London P S, Some observations on the course of events after severe injury of the head, Ann R Coli Surg Engl 41:460--479. 1967
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