Head Injury, Age 3 and Younger

Topic Overview

Almost all children will bump their heads, especially when they are babies or toddlers and are just learning to roll over, crawl, or walk. These accidents may upset you, but your anxiety is usually worse than the injury. Most head injuries in children are minor.

Head injury occurs more often in young children than adults. When compared with adults:

• Young children cannot control the movement of their heads as well as adults.
  • Their heads are larger in relation to their bodies.
  • Their neck muscles are not as well developed.
• Young children's legs are relatively shorter in proportion to the rest of their bodies. This makes a child's center of gravity closer to the head than an adult's center of gravity.
• Young children are more likely to have an accident or fall as they learn new skills such as walking, running, and jumping.

Bumps, cuts, and scrapes on the head and face usually heal well and can be treated the same as injuries to other parts of the body. A superficial cut on the head often bleeds heavily because the face and scalp have many blood vessels close to the surface of the skin. This bleeding is alarming, but often the injury is not severe and the bleeding will stop with home treatment. See how to stop bleeding. When bleeding does not stop with home treatment, visit a doctor because a young child can lose a large amount of blood from a deep cut on the head.

The most common serious head injuries in young children are caused by falls and abuse (inflicted head injuries). Serious head injuries may involve injuries to the brain. The more force that is involved in a head injury, the more likely it is that a serious injury to the brain has occurred. If there has been a high-energy injury to the head, there is a greater likelihood that a serious injury has occurred. When a high-energy injury occurs, it is even more important to assess the child for signs of a serious head injury.

Shaken baby syndrome is thought to occur when a baby is violently shaken, thrown, or slammed, causing the baby's head to move forward and backward rapidly. This movement causes the brain to hit the sides of the skull forcefully, leading to bleeding in the eyes and injury and bleeding in the brain. Brain injury and bleeding can cause increased pressure in the brain. Increased pressure in the brain can lead to serious, permanent brain damage. Babies who have trouble breathing or who stop breathing during an episode of being shaken, thrown, or slammed may have more brain damage.

Following an injury, it can be difficult to tell the difference between a mild traumatic brain injury (concussion) and a more serious brain injury. Watch the child carefully for 24 hours after a head injury to see whether he or she develops any signs of a serious head injury.

When a head injury has occurred, look for injuries to other parts of the body. The alarm of seeing a head injury may cause you to overlook other injuries that need attention. Difficulty breathing, shock, spinal injuries, and severe bleeding are all life-threatening injuries that may occur along with a head injury and require immediate medical attention. Injuries to the spine, especially the neck, must be considered when a head injury has occurred.

Many head injuries can be prevented. Use car seats, seat belts, helmets, and make your home safe from falls to prevent an injury. Establish good safety habits early so your child will continue them when he or she is older.

Review the Emergencies and Check Your Symptoms section to determine if and when your child needs to see a doctor.

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Author:	Sydney Youngerman-Cole, RN, BSN, RNC	Last Updated July 12, 2006
Medical Review:	William M. Green, MD - Emergency Medicine Michael J. Sexton, MD - Pediatrics Emmett Francoeur, MDCM, CSPQ, FRCPC - Pediatrics
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