Injury and Pain Care

Head injury is a broad term that describes injuries to the scalp, skull, brain, and tissue and blood vessels in the child's head. Some head injuries are also called brain injury, or traumatic brain injury (TBI), depending on the extent of the head trauma. Concussion is the most common type of TBI.

During the first few weeks after a head injury your child may:

• Have mild or moderate headaches. Make sure to ask your healthcare provider (doctor or nurse practitioner) what you can give your child to help treat his headaches. Generally, your child should not take ibuprofen, aspirin, or naprosyn if he has an intracranial hemorrhage, or bleeding in the brain.
• Be more sleepy
• Be more irritable, cranky, or moody
• Have a shorter attention span and poor memory
• Feel dizzy from time to time
• Have an upset stomach
• Vomit 2 or 3 times during the first week home

1. Follow instructions provided by your healthcare provider

   It is important that your child follow all of the special instructions given by your healthcare provider to make sure that your child heals completely. The following are general suggestions for children with head injuries.

2. When to call the doctor

   Make sure to ask your healthcare provider what symptoms to look out for and whether you should call or go straight to the hospital. Some of these symptoms are:

   • A very bad headache not helped by any of your doctor's recommendations
   • It is hard to wake up your child and he tends to fall back to sleep shortly after being awakened, even during the day.
   • A major change in behavior (for example: confused, impulsive, reckless, aggressive, or abnormal behavior.)
   • Frequent vomiting or cannot keep any liquids down.
   • Bloody or clear fluid from the nose or ears
   • Dizziness
   • Unsteady on his feet or sways when he walks
   • Weakness in the arms or legs
   • Seizure (twitching or jerking movement of parts of the body; may look stiff) or staring spells
   • Changes in visions:
     • Blurred or double vision
     • Appears to have trouble seeing
   • Trouble hearing
   • Seems to be getting worse instead of better
   • New problems in school (for example: with attention, memory, and behavior)
   • If you have any other concerns
3. Make sure to ask your healthcare provider:
   • What symptoms should I look for in my child? How often should I check?
   • What should I do if my child has a symptom you told me to watch for? Should I call the office, call 911, or go to the hospital?
   • Can my child return to school?
   • What are the limits to my child's activity?
   • When can my child start gym? contact sports? biking? or rough play?
   • Will my child need any kind of testing or therapy?
   • Will my child have any learning problems because of the injury?
   • Will you please call my child's school and explain head injury and what they need to know about my child?
4. Suggestions for follow-up appointments.

   When you bring your child in for his follow-up visit and afterwards, remember to:

   • Let your healthcare provider know if your child has trouble doing things he was able to do before the injury (including schoolwork)
   • Talk with your healthcare provider about seeing a Pediatric Rehabilitation doctor if your child has new problems with attention, memory, behavior, or school that last for more than a month after the injury.
   • Let your healthcare provider know if your child has persistent headaches; he may refer you to a neurologist.
5. Returning to school:
   • Ask your healthcare provider when it is okay for your child to return to school. He may suggest that your child start with half days. Let your child's teacher know about the injury so that the teacher will be looking for any change in school performance or behavior. You may need to get a prescription from your child's doctor for the school nurse to administer even over the counter medication like ibuprofen, acetaminophen, or naprosyn.
6. Returning to contact sports and rough play;
   • Check with your child's healthcare provider to see when he is able to return to sports/rough play. Generally, activity restrictions include any activity where your child could fall or hit his head again, which includes things like contact sports, rough play/wrestling, gym, recess, bike riding, skateboarding, skiing, among others.
7. For more information and resources on injury care, click here.
8. Decrease your child's risk of future injuries. Click here for more information.
9. Full recovery goes beyond physical healing - learn more about your child's emotional recovery after an injury, and how you can help.