Head or Brain Injury

Head injury is a broad term that describes many different types of conditions — ranging from bumps and bruises to concussions, skull fractures, and serious brain injuries. While some head injuries do cause lasting damage, most kids recover with no long-term problems.

There are several types of head injuries:

• Scalp injuries, such as bumps and scrapes: Because the scalp has so many blood vessels, even a small cut can bleed a lot, and a mild knock on the head can leave a scary-looking bump. Thankfully, most of these injuries are just surface wounds and heal within a matter of days.
• Skull fractures: Skull fractures are breaks in one or more bones in the skull. Most skull fractures heal on their own and don’t require surgery, but children with these injuries may need to be observed in the hospital for a short time.
• Hemorrhages: Hemorrhages, also called hematomas, occur when there is bleeding in the brain. Depending on where the bleeding occurs, children with these injuries may need surgery.
• Traumatic brain injuries (TBIs): TBIs occur when a sudden jolt, blow, or bump to the head affects the brain. In some cases, symptoms of TBIs may not appear right away. Concussions are the mildest and most common type of TBI. More severe TBIs can cause permanent brain damage.

The following symptoms may appear right away, or days or weeks after the injury:

• Headache
• Tiredness
• Sensitivity to noise or light
• Irritability or persistent crying
• Lightheadedness or dizziness
• Problems with balance
• Nausea
• Problems with memory or concentration
• Sleeping more or less than usual
• Restless, agitated, or unusual behavior
• Not wanting to eat or nurse
• Loss of interest in playing

If your child has any of these symptoms after a head injury, call your doctor.

If your child has any of the following symptoms, seek emergency care right away:

• Trouble with balance or walking
• Vomiting or nausea
• Slurred speech
• Extreme tiredness or trouble being awakened
• Seizures or convulsions
• Loss of consciousness (passing out)
• One pupil (black center of the eye) is larger than the other

Nearly any type of trauma can cause a head or brain injury in a child. Some of the most common causes include:

• Falls
• Sports injuries
• Motor vehicle accidents
• Being hit by an object or another person

The doctor will examine your child and ask about his or her symptoms, medical history, and how and where the injury occurred.

What tests will my child need?

To help diagnose a head or brain injury, your child’s doctor may also order one or more of the following tests:

• Speech, language, or cognition tests: Doctors use these tests to see if the head injury has affected any of your child’s brain functions, such as speaking, reading, or memory.
• Computed tomography (CT) scans: CT scans use X-ray equipment and powerful computers to create detailed images of the head and brain. A CT scan can show bruised brain tissue, bleeding in the brain, and other brain damage.
• Magnetic resonance imaging (MRI): MRI uses a combination of electromagnets and radio waves to take detailed images of the brain.
• Intracranial pressure monitoring: In some cases, a traumatic brain injury can cause swelling in the brain that increases pressure in the skull. The doctor may place a probe in the skull to check this swelling. If the pressure gets too high, a shunt or drain may be used to relieve this pressure.

Treatment for mild head injuries

The most important treatment for mild head injuries, such as concussions, is physical and mental rest. This gives the body a break from moving and thinking, so the brain can heal. Your child’s doctor will give you a schedule to increase your child’s activity levels once the symptoms have gone away. Doing too much before the brain has fully healed can slow recovery and may cause lasting problems.

Treatment for severe head injuries

Treatment for more severe head injuries varies depending on your child’s injury. Options may include:

• Surgery to repair breaks or bleeding
• Placing drains or shunts in the skull to reduce extra pressure
• Medications to help prevent blood clots, muscle spasms, and seizures 

The Boston Children's Hospital Brain Injury Center provides comprehensive care to children and adolescents with any type of head or brain injury. Learn more about how the center treats brain injuries, from early response and inpatient care to long-term follow-up.

Extra support for serious brain injuries

Some brain injuries can cause problems with movement, behavior, speech, vision, hearing, or taste. Children with these injuries may need more long-term support, including:

• Psychosocial care and counseling
• Physical therapy
• Speech therapy
• Vision support
• Hearing support

Expert care for head and brain injuries

Boston Children's Hospital has been a worldwide innovator in diagnosing and treating pediatric head and brain injuries for decades.

Helpful links

You can learn more about head and brain injuries on the following websites:

• Brain Injury Association of America
• Brain Injury Support Group (DailyStrength.org)
• Brain Trauma Foundation
• Child Brain Injury Trust (UK)
• Head Injury Association
• International Brain Injury Association
• The Sarah Jane Brain Foundation
• ThinkFirst National Injury Prevention Association