Head Injury - Children

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What about a head injury in infants and young children?

A minor head injury in an infant is described by the American Academy of Pediatrics as the following, "A history or physical signs of blunt trauma to the scalp, skull, or brain in an infant or child who is alert or awakens to voice or light touch."

In children and infants younger than 2 years of age, it is more difficult to assess their mental status and guidelines that work for adults do not necessarily apply to this age group. The Pediatric Emergency Care Applied Research Network (PECARN) has developed an algorithm that helps decide when a CT scan of the head might be appropriate.

For children younger than 2 years of age:

CT scan is recommended for those patients with a Glasgow Coma Scale of less than 15, altered mental status, or a palpable skull fracture.

For those with a Glasgow Coma Scale of 15 but with an occipital, temporal, or parietal hematoma (that is swelling on the back or side of the head), significant trauma, or loss of consciousness for greater than 5 seconds, or for those not acting normally according to their parents, a CT scan may be considered based upon the following:

  • physician experience,
  • multiple physical findings,
  • worsening symptoms during observation in the ER,
  • age less than 3 months, or
  • parental preference.

For all others, CT scan is not recommended.

For children older than 2 years of age:

CT scan is recommended for those patients with a Glasgow Coma Scale of less than 15, altered mental status, or a basilar skull fracture.

For patients with loss of consciousness, vomiting, severe headache, or a severe mechanism of injury, a CT scan may be considered based upon the following:

  • physician experience,
  • multiple physical findings,
  • worsening symptoms during observation in the ER, or
  • parental preference.

For all others, CT scan is not recommended.

Return to Head Injury (Brain Injury)

See what others are saying

Comment from: Mom, 0-2 Female (Caregiver) Published: November 04

Two weeks after my daughter's 2nd birthday we were about to watch Saturday morning cartoons. My parents had a 25 inch television on a stand with rolling castors and double doors. She was in front of the TV when I told her to move away and started to get up to get her. She opened the doors and acting as levers the television fell on top of her covering her whole body, smashing her head against the hardwood floor. I was not 8 ft. from her and I could not get to her in time. Twenty years ago, 25 inch TVs were very large and heavy. I threw the TV across the room and I remember thinking why aren't you crying? She was not even breathing. She suffered a closed head injury and cranial nerve damage. In that one split second all of our lives changed. She coded three times on the way to the hospital. We spent a month in children's hospital. They had a unit where parents could stay with their child. They said she would not improve, after about a year. She is the strongest person I know. She still has to work at staying in control and staying on top of things but she is a beautiful and capable young woman with a three year old daughter! She needs a TBI (traumatic brain injury) specialist and probably always will. It is a nightmare that never ends. The guilt, frustration, anxiety and grief are still present every day and that is just my pain. I cannot even imagine the pain, emotional and physical, that she has experienced. She needs to be more independent. I will not be around forever and I need to know that she will be okay.

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Comment from: ikky, 25-34 Female (Caregiver) Published: March 12

My child suffered a head injury years ago and appeared fine, except a knot formed in the middle of her forehead after several days had passed. Currently she has behavior problems that appear to be schizophrenic and could be a danger! Recent hospitalization has helped some with the depression and anxiety. A recent visit, and with me she appears rational. I am concerned that the childhood trauma was more severe and that the knot may be a hemorrhage that gone undetected.

Was this comment helpful?Yes

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