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Medical Author:

Benjamin Wedro, MD, FACEP, FAAEM

Benjamin Wedro, MD, FACEP, FAAEM

Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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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.

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