“It cannot be denied that children are in an age of curiosity and learning, so they may play and be mischievous like children usually do without being careful, which can lead to accidents such as falls, loss of consciousness, seizures, and especially head injuries. Therefore, parents should watch out for head injuries in children to reduce the risk of accidents. If an injury does occur, parents should strictly follow the recommendations of medical specialists to reduce the severity of potential side effects that may follow.”
Head Injuries: A Common Condition in Children
Dr. Chayut Chanmanon, a specialist in neurosurgery, provided information about head injuries(Head injury), stating that head injuries are frequently found in children and are difficult to assess because children often cry and become upset, causing parents to feel troubled and confused about when to bring the injured child to see a doctor. How severe must the symptoms be? Should they wait to see the symptoms first? This is why parents need to know how to properly care for head injuries in children at such an active age.
Call an Ambulance or Take to the Doctor Immediately if Your Child Experiences These Head Injury Symptoms
- Head injury from high speed or height, such as motorcycle, high-speed bicycle, skateboard, falling from playground equipment or falls from a height greater than 1 meter.
- The child is unconscious, cannot remember the event, or has seizures after the accident.
- The child appears drowsy, fatigued, or vomits two or more times after the accident.
The Severity of Head Injuries
Currently, head injuries are categorized into three levels of severity: mild, moderate, and severe.
- Mild Head Injury: The most common type of injury in children, caused by incidents like bumping heads while running or falling off a bicycle or bed. This category can further divide the risk of injury into three levels: low, medium, and high, which helps to determine the appropriate treatment method.
- Low Risk of Mild Injury: Caused by minor accidents. The child may only have bruises and scrapes, be crying or upset without drowsiness or fatigue. Parents or caregivers can monitor the symptoms at home. If the symptoms worsen, the child should be taken to the hospital immediately.
- Moderate Risk: The child might be sleepy but can be awakened, may become unconscious or have memory loss, experience headaches, or vomit fewer than 2 times. For these cases, doctors usually recommend observing the symptoms in the hospital for at least 6 hours. In this group, a CT brain scan is required.
- High Risk: The child may be drowsy but can be awakened, vomits more than 2 times, has seizures, or neurological signs such as limb weakness. A CT brain scan is necessary for all cases in this group.
- Moderate and Severe Head Injury: This involves children who have reduced awareness, such as being lethargic or unresponsive, barely moving, showing weakness, or being confused. Children in these two groups must be taken to see a doctor urgently at the hospital.
When Should Parents Take Their Children Back to See a Doctor?
When the child is sent home for treatment and observation, parents should understand how to monitor the child closely for at least 24 hours. They should wake the child every 2-4 hours within the first 24 hours to assess whether the child’s consciousness has decreased.
If the child shows any of the following symptoms, they must be brought back to see the doctor immediately for reassessment:
- Increased lethargy, cannot be awakened, or unconsciousness
- Restlessness, abnormal speech or behavior
- Seizing
- Weakness in arms and legs
- Fever
- Frequent vomiting
- Persistent headache not relieved by pain medication
- Clear fluid or watery blood discharge from ears, nose, or down the throat
- Neck pain, difficulty bending the neck
- Dizziness, blurred vision, or double vision
- Any other suspicious symptoms requiring medical consultation
References
- Royal College of Surgeons of Thailand, Department of Medical Services, Ministry of Public Health, Office of the Permanent Secretary, Ministry of Public Health, Institute of Neurology, Department of Medical Services, Ministry of Public Health, Department of Air Force Medicine, Office of the Higher Education Commission, Clinical Practice Guidelines for Traumatic Brain Injury; 2019.
- Surasak Yuttakasem, Documentation published by the Working Group for the Treatment Guidelines for Head Injury, Institute of Neurology, Bangkok; November
- American College of Surgeons Committee on Trauma. Advanced Trauma Life Support Student Course Manual. 10 ed: American College of Surgeons; 2018.
- Carney N, Totten AM, O’Reilly C, Ullman JS, Hawryluk GW, Bell MJ, et al. Guidelines for the Management of Severe Traumatic Brain Injury, Fourth Edition. Neurosurgery. 2017;80(1):6-15.
Best wishes from
Neurosurgical Specialist
Surgery Department | Bangkok Hospital Chiang Mai
For more information, please contact:
Surgery Department
Phone 052 089 863
Call Center: 1719
“Open Monday – Sunday from 08.00 – 22.00 hrs.”
