Head injury in children

Children are incredibly active and they have little sense of danger so it is not surprising that they are prone to head injuries. In addition, their heads are large in proportion to their bodies and therefore more vulnerable to damage than adult heads. Head injuries may involve the scalp, the skull, the brain or its protective membranes.

Skull fractures

These may be uncomplicated, in which case they can heal without surgical treatment. However, a depressed skull fracture, where part of the skull bone has been pushed inwards, may require surgery to lift the bone and prevent it pressing against the brain.

If the scalp is injured and there is an underlying skull fracture that exposes the brain, an operation will usually be needed to clean the wound and repair the damaged skin and bone.

The force to the head during injury can make the brain move within the skull. As the inside surface of the skull is rough, the following injuries can occur:

Cerebral lacerations are tears to the surface of the brain, which sometimes happen after the skull is fractured. Bleeding can occur in and around the tear.

Cerebral contusions are bruises to the brain, caused when the brain bounces off the inside of the skull. Contusions can cause parts of the brain to swell, which may make your child irritable, sleepy or sick.

Shearing injuries tear the nerve fibres and blood vessels. These injuries often lead to swelling of the brain, contusions (bruises) or blood clots.

Possible complications of head injury

Swelling of the brain affects most children after a severe head injury. It can occur within hours or it may not happen for a few days. This swelling causes a rise in pressure within the brain

Seizures (fits/convulsions) may happen immediately after the injury or several days later. They are generally caused by irritation to the brain from swelling or bleeding. If your child suffers a seizure or a convulsion, it does not mean that they have epilepsy or will continue to have seizures for the rest of their life.

MCP First Aid Training provides a comprehensive range of approved training courses in paediatric first aid.

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