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Head Injury (cont.)

Head Injury in Infants and Young Children

Infants often visit health care practitioner because of a head injury. Toddlers tend to fall as they learn to walk, and falls remain the number one cause of head injury in children. While guidelines exist regarding the evaluation of head injury victims, they tend to be applied to those older than 2 years of age.

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.

Infants are usually unable to complain about headache or other symptoms. Therefore, basic guidelines as to when to seek medical care can include the following:

  • Altered mental status. The child is not acting or behaving normally for that child.
  • Vomiting
  • Scalp abnormalities including lacerations and swelling that may be associated with skull fracture Forehead contusions tend to be less worrisome than occipital (back of the head) contusions
  • Seizure

Often a careful physical examination is all that is needed to assess the infant's risk for intracranial hemorrhage, but some testing may be considered.

CT scan may be indicated based upon the health care practitioner's assessment of the child. Plain skull X-rays may be considered to look for a fracture, as a screening tool to decide about the need for a CT scan.

Usually, if the health care practitioner finds no evidence for concern, the infant can be discharged home for observation. While parents may choose to, there is no need to keep the infant awake or waken them should they fall asleep.

Medically Reviewed by a Doctor on 9/4/2015

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Head injury can be defined as any alteration in mental or physical functioning related to a blow to the head.

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