Head or Brain Injury | Overview
What is a head 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.
What are common symptoms of a head or brain injury?
The following symptoms may appear right away, or days or weeks after the injury:
- sensitivity to noise or light
- irritability or persistent crying
- lightheadedness or dizziness
- problems with balance
- 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.
What symptoms need emergency care?
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
Types of head injuries
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.
What causes head and brain injuries in children?
Nearly any type of trauma can cause a head or brain injury in a child. Some of the most common causes include:
- sports injuries
- motor vehicle accidents
- being hit by an object or another person
How we care for head and brain injuries
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.
Head or Brain Injury | Diagnosis & Treatments
How is a head or brain injury diagnosed?
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.
How we treat head injuries
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
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:
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. Learn more about how the Brain Injury Center helps children who have head and brain injuries.
You can learn more about head and brain injuries on the following websites:
Head or Brain Injury | Frequently Asked Questions
Will my child be OK?
While some head injuries do cause lasting damage, most kids recover from head injuries with no long-term problems. The most important thing you can do for your child after a head injury is to seek medical attention right away. The earlier a head injury is diagnosed and treated, the better the general outlook.
How common are brain injuries in children?
The Centers for Disease Control and Prevention (CDC) reports that nearly half a million children ages 14 and younger are treated in emergency rooms for brain injuries each year.
Can head and brain injuries be prevented?
There is no way to completely prevent all head or brain injuries. But you can reduce your child’s risk of a head injury by taking these steps:
- Promote a safe playing environment, such as using playground equipment and toys that are appropriate for your child’s age.
- Ensure that your child is wearing a seat belt or is properly secured in a car seat whenever riding in a car.
- Make sure your child always wears a helmet while bicycle riding, in-line skating, skateboarding, or while doing any other sports or activities that carry a risk of head injury.
What do the terms ‘open-head injury’ and ‘closed-head injury’ mean?
An open-head injury is one that has broken through the scalp. A closed-head injury is a hard blow that does not pierce the scalp.
What symptoms do I need to watch for after a head injury?
If your child has been diagnosed with a head injury, you should watch for any changes in your child’s:
- balance or coordination
- pupil size
- sleep patterns or behavior
Report any changes to your child’s doctor right away.
Will my child recover completely from a head or brain injury?
Children who have mild to moderate head and brain injuries usually recover completely or have only minor complications, with time, rest, and proper medical care. In some cases, severe brain injuries can cause permanent damage.