If a child falls: injuries in children. Are head impacts dangerous in young children? Consequences after a head injury in a child

The child does not sit still. He strives to be in time everywhere, to know everything. Their excessive physical activity and curiosity sometimes surprises an adult. They can run, jump, and dance for several hours at a time. Children do not always have enough life experience to assess the danger of a situation, and therefore injuries are not uncommon among them. And some of the most dangerous are head and brain injuries. Signs of this type of injury in children are not always immediately noticeable. They often hide the bruise from their parents or simply do not focus attention on it. Often, head injuries are treated with minor abrasions, bruises and bumps, but sometimes they carry serious consequences.

In order to understand the severity of brain injuries that can occur in children, we need to more thoroughly understand their types, symptoms, and treatment methods. Often, parents mistake a serious head injury to their son or daughter for a minor blow and do not go to the hospital, thereby endangering their children.

Closed craniocerebral injury in a child: main signs and consequences

Traumatic brain injury (TBI) can be caused in children by a fall, a blow, or even a sudden stop while running or, conversely, an unexpected acceleration. This is explained by their curiosity, restlessness, high physical activity, as well as the lack of a sense of danger and fear of heights. It is worth keeping in mind that the weight of babies' heads is relatively large, so most often they fall down without even having time to put their hands up. Over 90% of TBIs in infants are caused by parental neglect. By turning away for just one second, an adult may miss the moment when the baby rolled over from the changing table, fell out of bed, or rolled off the sofa. When a child gets to his feet, brain injuries are caused not only by falls from his height, but also from stairs, tree branches, children's slides, etc. At this age, a closed brain injury that occurs in a child may be invisible to parents - they often do not even suspect it. Sometimes older children themselves hide trauma from their parents, and sometimes they don’t even understand what’s really happening to them. In preschool children, head trauma can occur even from excessive motion sickness in automobile or train transport. Following from the above, parents must be extremely attentive to the ongoing processes in the child’s life in order to promptly detect the main symptoms of a traumatic brain injury.

Fortunately, 90% of brain injuries are concussions, which rarely cause complications. Do not forget that the brains of adults and young children have significant differences. If an adult experiences a headache, a momentary loss of consciousness and even amnesia with such an injury, then the signs of a traumatic brain injury are often asymptomatic in infants and slightly noticeable in a school-age child. In the smallest children, you may notice pale skin, lack of appetite, restlessness or lack of sleep, and regurgitation during feeding. Here the parent must be extremely attentive to all the changes occurring with his child. The consequences of a traumatic brain injury in a schoolchild or a child 3-6 years old can include vomiting, excessive sweating, surges in blood pressure, and headache. Very rarely, post-traumatic blindness can occur, which lasts from a few minutes to several hours, but then disappears on its own. You shouldn't be afraid of her and you should just wait. The child’s body is designed in such a way that symptoms can increase only after some time, but not immediately after the blow. Any identified traumatic brain injury immediately requires treatment in children, so parents urgently need to consult a doctor.

How to determine a concussion in a child: how the first signs appear

Shake This is the mildest type of brain injury. As a result of a fall or blow to the head, microcirculation in the brain is disrupted at the level of small vessels. Swelling occurs, which compresses the brain tissue. If a child loses consciousness for some time after an injury, this may indicate a concussion. After the child comes to his senses, he develops symptoms such as headache, dizziness, nausea, and pallor. Another important symptom is short-term memory loss. The effects of the injury last for about a week.

The main symptoms of a concussion in an infant and school-age child are, first of all, nausea, as well as severe weakness. Then the victim becomes more irritable and experiences increased drowsiness and fatigue. Quite rarely, in this case, vomiting or headache may occur. If a child exhibits these signs of a concussion, it is better for parents to contact a neurologist, traumatologist or neurosurgeon. The specialist will conduct an inspection, carefully studying all complaints. If necessary, additional diagnostic methods may be prescribed for a child to diagnose a concussion. For young children, this method most often becomes neurosonography or radiography. After a concussion is detected in a child, he is prescribed treatment.

What to do if a child has a concussion and the consequences of the injury

At home, you can independently detect a concussion based on the above symptoms in your child, but making sure there are no skull cracks, displacements, hemorrhages and prescribing the correct treatment will be extremely difficult, or rather, simply impossible. Therefore, only a doctor can tell you how to identify a concussion and correctly diagnose it in a child. Probably the best method for detecting skull injuries and brain damage today is computed tomography. It is CT that is more effective and also common in medical institutions.

As soon as children show the first symptoms of a concussion, parents need to give rest to the victim. If bleeding occurs from a wound, you need to urgently treat it and bandage it. It is worth remembering that a concussion that occurs in children of any age can be cured only by starting with hospitalization. In a hospital setting, complications of a concussion can be prevented, the consequences of which in a child can be hematomas inside the skull and cerebral edema. Such complications are extremely rare, and they are also signs of a concussion that you can detect in your child. In the hospital, the victim has psycho-emotional peace due to the absence of any kind of activity - neither social nor motor. The length of stay in a medical facility is often limited to 2-4 days. After discharge, for a period of 1-2 weeks, he is prohibited from playing sports, leading an active lifestyle, and also spending a lot of time watching TV and using the computer.

The main principle of therapy is rest and vigilant supervision by specialists; medication treatment of concussions in children also takes place. To prevent the formation of edema, the patient is prescribed diuretics in combination with potassium. In the presence of headaches, analgesics are prescribed; antihistamines or sedatives are rarely prescribed.

If you do not contact a specialist in time, the child may have quite serious consequences of a concussion. These include frequent headaches, periodic vomiting, irritability from favorite games, sleep disturbances, inhibited reaction when performing daily tasks, and weather dependence. The most dangerous consequence of this injury may be the occurrence of post-concussion syndrome. Sometimes it can appear only after a few months, and for some even after a couple of years. It is expressed by a sharp headache, sudden dizziness and blurred vision. Treatment of this symptom does not make sense. Most often, children simply get used to these changes over time.

The above-described consequences after a concussion, which appear in a child after the injury has occurred, are mistakenly taken by parents to be the first signs of a concussion that has occurred in a child, so it is very important not to confuse them, so as not to be late in making a diagnosis. Adults need to be attentive to the health and general well-being of their child. To do this, it is important to know exactly how a concussion manifests itself and its first symptoms in a child. If parents are delayed in seeing a doctor, the victim may be prescribed nootropic drugs or special vitamins.

To summarize, it is important to note that concussions are quite common in children. Basically, they do not pose a danger to further development, but medical diagnosis and proper treatment are necessary here to eliminate negative consequences, especially if the resulting concussion does not occur for the first time. If parents panic, they do not know what to do when a concussion is detected in their child. You need to ensure the victim’s peace, call a doctor, or go to the nearest hospital yourself. Next, doctors take over the treatment of the children, and the relatives only need to ensure a calm lifestyle for the victim for at least a week.

Brain contusion in a child: main symptoms, treatment and consequences

A brain contusion is a more serious injury. Often a bruise is also called a concussion. The main symptom of this traumatic brain injury is loss of consciousness. It can be mild, moderate and severe. With a mild injury, the symptoms of brain damage are similar to a concussion, but accompanying cracks and even small fractures of the skull bones are possible. With this injury, the child is usually unconscious for more than half an hour. After restoration of consciousness, difficulty in moving the limbs is observed. With a moderate brain contusion, the child may remain unconscious for up to several hours. Symptoms of central nervous system dysfunction are more severe. A severe injury is characterized by pronounced signs of neurological disorders. The child may remain unconscious for up to several days. Fractures of the skull bones are possible, the most severe of which are open. A brain contusion is accompanied by hemorrhage into the space under the meninges. Great value for identifying severity
In case of a brain contusion in a small child, the impact occurs on the forehead, central gyri, temples, parietal region, back of the head, or base of the brain. The following symptoms depend on this.

Parents, first of all, need to treat the wound if it is bleeding or apply ice to the site of the hematoma. But what to do if no damage is found in the child at the site of the brain contusion. In this case, adults need to show increased attentiveness to the behavior of their baby. Based on the symptoms, you can determine the presence of a bruise and call an ambulance as quickly as possible.

When a child has a blow to the frontal lobe, the main symptoms of a brain contusion may include nausea, vomiting, pale facial skin, dilated pupils, sluggish speech, and heaviness of breathing. Blue lips, a sharp increase in the lump at the site of the impact, and blood protruding from the nose or ears may often be observed. Even one of the above signs is evidence of a bruise and may cause an emergency call.

If the victim hits the back of the head, then memory impairment, double vision (visual hallucinations) and numbness of the limbs may be added to the listed symptoms. When the gyral area is hit, alarming symptoms of a brain contusion in children are loss of reflexes and the appearance of convulsions. When the temples become the affected area, auditory hallucinations and writing disorders may occur. Bruises of the crown are very difficult to identify, especially for infants, as they are manifested by tactile disorders and decreased sensitivity. Contusions to the base of the brain are often accompanied by fractures of the skull bones.

A concussion or bruise is very difficult to diagnose at first, and therefore consultation with a specialist is mandatory. The method of treating a bruise differs significantly from the treatment of a concussion. The victim requires emergency medical care. In any case, you should call a doctor or take the child to the emergency room. In case of fractures of the skull bones or damage to soft tissues, apply a sterile bandage to the head and apply an ice pack to the head. It is not recommended to give your child any medications. Having assessed the severity of the injury, the doctor decides on possible immediate hospitalization in the intensive care unit. For mild brain injuries, rest and bed rest are prescribed, as well as observation by a local doctor. Painkillers, sedatives, and antiemetics are prescribed. In severe cases, urgent hospitalization is indicated with the full range of measures to resuscitate the injured child. In the future, the doctor prescribes restorative treatment depending on the prognosis.

To determine the degree of damage in a child and prescribe proper treatment for a brain contusion, it is necessary to assess the state of his respiratory and cardiovascular systems and perform a neurological examination. The most common methods for making a diagnosis are computed tomography and magnetic resonance imaging. Further, depending on the severity of the bruise, treatment can occur in two ways - surgical and therapeutic. The first is used when it is necessary to remove the physical factor of compression of brain tissue (hematomas, bone fragments, hemorrhages), which is performed by osteoplastic trepanation. The therapeutic method is drug treatment to eliminate increased intracranial hypertension. We must not forget about prevention in order to prevent cerebral edema from forming. If swelling does occur, doctors inject hypertonic solutions into the blood or use diuretics for a longer effect. Treatment periods range from 1 to 12 months, depending on the severity of the injury. In this case, a minimum of three weeks of bed rest is recommended.

The consequences of a brain contusion can last from 15 to 20 days in children with a good outcome. They are often divided into intracranial and extracranial. The most dangerous are intracranial - meningitis, abscess and encephalitis, which appear even three months after the injury. Extracranial consequences in a child with a brain injury are asthenic syndrome (increased fatigue, irritability, withdrawal), a sharp increase or decrease in blood pressure, impaired liver and kidney function, as well as pneumonia. Epilepsy occurs very rarely in victims; this happens in 10-20% of children and can appear only after 1.5 years. Fortunately, children's physiological characteristics do not allow the development of consequences of a high degree of severity due to brain contusions, but this does not mean that treatment can be neglected. Any blow to the head requires careful attention from adults to the victim, his hospitalization and impeccable compliance with the doctor’s instructions.

It must be remembered that a head injury, especially when it comes to an infant, requires seeking medical attention. It is impossible to cure a bruise at home on your own, since such a head injury is fraught with serious consequences.

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The cause of a brain contusion in a child can be either a fall or a blow. A blow, also known as intentional infliction of bodily harm, is a matter within the jurisdiction of the court, and one must be held accountable for it before the law. In this regard, the most relevant and correct for this article would be to list unintentional injuries - that is, those that the baby could receive on his own or due to parental oversight.

In fact, there can be an incredible number of similar situations. As soon as the baby learns to sit, there will be even more of them. And when he learns to walk - more and more. Sometimes mom and dad are unable to keep track of the baby, and sometimes the baby gets injured only because the parents underestimated his agility. So, here are a few situations that parents of an injured child most often tell traumatologists and pediatric neurologists:

the baby was lying on the parent’s bed, the mother turned away (or walked away) for a second, the baby fell to the floor;
the child was left alone unattended in a children's high chair, the baby pushed off the footrest with his feet and fell out of the chair onto the floor;
the child was sitting in a stroller, stood up in it and fell, unable to sufficiently control his coordination due to his early age.

And this is not to mention the fact that an older child can receive a similar injury during any game with peers.

Symptoms

Symptoms of brain contusion in children are divided into focal and cerebral. Focal signs of injury include:

the formation of a swelling in the place that was in contact with a flat surface at the time of impact;
the appearance of symptoms of damage to local centers of the cerebral cortex (the appearance of visual disturbances, speech and others);
paralysis;
paresis.

In general, a lot depends on the age of the injured child. For example, a baby who is only a few months old simply does not have a speech center. And if so, then it cannot be damaged. Unlike a schoolchild who already has such a center.

General cerebral symptoms of a brain contusion in a child include the following:

headache,
vomit,
nausea,
loss of consciousness.

Diagnosis of brain contusion in a child

If the baby is about a year old or a little more, the doctor will suggest neurosonography as a diagnostic method. In essence, this is the same ultrasound examination, only through the area of the large fontanel. As long as it is not overgrown in a child, the brain can be examined through it. If the age of a small patient is older than one and a half years, he is prescribed a computed tomography scan. X-rays, which are involved in this diagnostic method, allow the doctor to obtain the structure of the child’s brain in a section - as if in layers. The same can be done when examining a magnetic resonance imaging scanner, which is not associated with X-rays.

Complications

Medical practice has shown that head injuries account for thirty or even fifty percent of cases of injury among children. Every year this percentage increases by another two percent. If the baby received a mild bruise, then, as a rule, there is nothing to worry about. However, if the degree of injury is moderate or severe, the situation can end very sadly. And disability in this case is not the worst thing. The worst thing is death.

Previously, it was believed that within a few weeks after receiving a bruise, the child’s body fully recovers. However, recent studies have shown that in some cases, echoes of a bruise make themselves felt even three months after the incident.

Treatment

What can you do

Parents can provide first aid for a brain injury. First you need to call an ambulance, and only then carry out first aid actions. In principle, if both parents are at home at the time of injury, one can take emergency measures, and the other can call the doctor. The division of responsibilities is quite obvious. However, in such situations, moms and dads often get lost and begin to panic.

If parents do not see noticeable damage to the cranial bones, something cold must be applied to the bruise site located on the child’s head. This can be either just a cloth soaked in water, or ice wrapped in a fabric base.
If the baby is bleeding, a special tampon must be applied to the wound. As soon as the first tampon is filled with blood, it would be advisable to place a second one on top of it.
If after fifteen minutes the blood continues to ooze with the same intensity, you will need to urgently call a doctor. However, if you call him immediately, before emergency measures are taken, then in fifteen minutes he will already be near the small patient.
The baby should not be touched, carried, or pulled. The child should be placed on the bed and left alone. However, under no circumstances should he be allowed to fall asleep in the first sixty minutes after receiving the injury. If he falls asleep, he needs to be woken up. Otherwise, there will be no opportunity to understand what exactly is happening to the baby. It is very important - if not the most important thing! - maintain parental calm. Panic from mom and dad can only worsen the situation and frighten the child. In a state of panic, the parent cannot help the child in any way, because he himself needs help.

What can a doctor do?

Children with brain contusions are treated exclusively in inpatient departments of hospitals and medical centers. The doctor prescribes drug treatment for such a patient to relieve swelling and bring blood flow inside the brain back to normal. If the situation is serious, the small patient may undergo surgery.

Prevention

To reduce the risk of a child suffering a brain injury, parents should:

Be sure to fasten the child in the stroller,
fasten the baby in a car seat (and in general, take him in a car only in a child seat, and not outside of it),
Fasten your baby in a highchair while eating.

Of course, keeping track of a baby who has a pain in the butt is not so easy. Children are very mobile and active creatures. No one is immune from sudden injuries, but parents can minimize the risks.

In the article you will read everything about methods of treating a disease such as brain contusion in children. Find out what effective first aid should be. How to treat: choose medications or traditional methods?

You will also learn how untimely treatment of brain contusion in children can be dangerous, and why it is so important to avoid consequences. All about how to prevent brain contusion in children and prevent complications.

And caring parents will find on the service pages complete information about the symptoms of brain contusion in children. How do the signs of the disease in children aged 1, 2 and 3 differ from the manifestations of the disease in children aged 4, 5, 6 and 7? What is the best way to treat brain contusion in children?

Take care of the health of your loved ones and stay in good shape!

There is no other sound that will send chills down your spine quite like the sound of your baby's head hitting a hard floor. Bruises and bleeding from the scalp top the list of calls to the doctor regarding injuries. It is important to distinguish a skull injury from a brain injury. The skull acts as a protective helmet for the fragile brain, and on top of the skull there is a scalp that is very rich in blood vessels.

In the vast majority of cases, bruises only lead to damage to the scalp, from which, when wounded, a lot of blood flows or from which large tumors (hematomas) form due to rupture of blood vessels under the skin. Don't be intimidated by how quickly these huge buds grow. They also go away quickly if you apply ice and pressure. These bumps and bleeding are usually limited to the scalp and rarely indicate that the underlying brain is affected.

The main concern after any head impact is brain injury, which can come in two forms: bleeding And concussions. When small blood vessels between the skull and brain or inside the brain rupture, bleeding occurs in that space and the pool of blood presses on the brain. Pressure on the brain due to bleeding or concussion accompanied by swelling gives clear symptoms of brain damage.

Take puncture wounds to the head seriously. They may seem trivial on the surface, but a nail, for example, can penetrate the scalp and skull and lead to dangerous inflammation of the brain. Let your doctor know right away.

What to Look for—When to Worry

If the child is unconscious but breathing and his skin is pink (lips are not blue), place him on a flat surface and call an ambulance. If you have reason to suspect a neck injury, do not move your child and leave the transportation to experienced professionals. If the child is not breathing, perform CPR, or if the child is having seizures, ensure that the child's airway is not blocked.

Sometimes, if the child is very impressionable and often throws tantrums, anger after a fall causes the child to hold his breath for a long time, which can be mistaken for convulsions. This naturally causes panic, and the parents rush to the hospital with the child. Even if it turns out that this was not necessary, it is better to be safe. Remember the words: “When in doubt, take your child and sit at the door of the emergency room.”

Observation period

If the child is clear-headed, walks, talks, plays and behaves in exactly the same way as before the fall, give him a dose of parental sympathy, apply an ice pack to the cut or bump for twenty minutes and observe before calling the doctor. The observation period is necessary because it is more important for the doctor to know how the child behaves after injury, not what happened. If the brain is damaged, symptoms may appear instantly, or they may slowly increase over the next twenty-four hours. After the observation period, depending on the child's condition, you may or may not call the doctor. In addition to any list of emergency situations when you need to urgently call the doctor, there is also an internal voice that drowns out everything and everyone, so valued by mothers, which is called the maternal alarm. You need to trust this monitoring system no less than any sophisticated electronics. If that inner voice tells you that all is not well, call your doctor and let him know about your baby's condition, ask for advice, and, among other things, tell the doctor why you are so concerned. Here's what to watch out for in the next twenty-four hours.

Changes in your child's sleep behavior

It is normal for young children to go to sleep after an injury, making the usual admonition to “watch to see if he regains consciousness” a source of terrible parental anxiety. If the head injury occurred late at night or at the usual nap time and the child was already tired before the injury, you may be wondering unsuccessfully whether the drowsiness is caused by the injury or whether it is simply time for the child to naturally fall asleep. And it may be completely impossible to follow the advice: “Just don’t let the child fall asleep.” Let the child sleep, but you wake up every two hours and examine the child.

Symptoms of Brain Damage

If your child has any of the following symptoms after a head injury, call the doctor or take your child to the hospital.

Loss of orientation, problems waking up;

Unusual breathing during sleep;

Strabismus, unequal pupils;

Uncontrollable vomiting;

Increasing pallor;

Blood or watery fluid oozes from the ear canal;

Convulsions;

The child loses balance when sitting, crawling or walking.

Pay attention to:

Change in skin color from pink to pale or, more dangerously, to blue;

Changes in breathing: periods of very shallow breathing, episodes of cessation of breathing lasting ten to twenty seconds, followed by uneven, irregular breathing, or periods when the child begins to gasp for air (remember that newborns' breathing is normally irregular);

Jerking on one side of the body, involving the whole limb.

If your baby's skin color and breathing are normal (no change from normal) and your parental intuition tells you that everything is fine, there is no need to wake your baby unless your doctor tells you to do so. The deep sleep that a child falls into after an injury is almost always accompanied by shallow, irregular breathing, which you have most likely never observed before.

If you are unsure or the appearance of the child causes you anxiety, try to partially wake him up. Sit your baby down or stand him down and then put him down again. Normally, the child will then fidget a little and toss around in the bed to get comfortable and fall asleep again. If your child behaves differently, try to fully awaken him by sitting him up or standing him up, opening his eyes and calling his name. If the child wakes up, looks at you, starts crying or smiling, and struggles so that you let him go and not bother him, you can safely go back to sleep. If your baby doesn't protest, can't wake up enough to cry, is pale, is breathing irregularly and drooling profusely, or shows any signs of brain damage, seek immediate medical attention.

Changes in balance and coordination

Signs of brain damage are easier to see during the day. Watch your child play. Does he do everything exactly the same as before the fall: sits up straight, walks well, moves his arms and legs normally? Or does he lose his balance, stagger, drag one leg, or become less and less oriented? If your child is not yet walking, do you notice any changes in the way he sits or crawls, or in the way he handles toys in his hands?

Vomit

Just as some children fall asleep after a head injury, other children vomit, mostly from the frustration of falling and pain. Do not worry. But uncontrollable vomiting for six to twenty-four hours is an alarming sign. Call your doctor immediately. To be careful, do not give a child recovering from an injury anything other than empty water for three to four hours. Breastfeeding has a therapeutic effect.

Eyes

The eyes reflect what is happening inside, especially inside the brain. The back of the eyes is so closely connected to the brain that when examining a child after a head injury, the doctor looks at the back of the eyes for signs of brain swelling. A child's eyes are more difficult to evaluate than other changes, but here's when to call a doctor: if the child has squinting or rolling eyes, if one pupil is larger than the other, if the child trips and falls or bumps into objects, which indicates vision problems. If the child is older, add to the list of alarming symptoms complaints that there is double vision or one continuous spot in front of the eyes.

How about a skull x-ray?

Except for severe head injuries or obvious fractures, skull x-rays are rarely necessary; There is also no need to take a happily playing child to the hospital for an x-ray. First observe; then call your doctor; and only then will advice be given as to whether the child should have an x-ray. Axial computed tomography, which is a series of x-rays of cross-sections of the brain, has almost completely replaced conventional x-rays. In most cases, if a child needs an x-ray, it is better to do an axial tomography. This technological breakthrough provides much more information about the injury, such as whether there is bleeding or swelling in the brain.

In honor of the simple ice pack

Children with bruises are not very friendly towards cold objects applied to the sore spot. Cold relieves pain, reduces bleeding and hematoma. But just not bare ice on bare skin, Please. This can lead to tissue frostbite. You can buy instant ice packs that don't leak and keep them in your medicine cabinet, or you can make your own by putting ice cubes in a sock or handkerchief. If you are using a plastic bag, wrap it in a thin cloth or wet napkin. Crushed ice in a sock produces a bag that can be easily shaped into any shape. You can keep ice cubes in reserve in a terry cloth toy. In our freezer we always keep the “Bo-bo rabbit”, which has become a reliable friend of bumps and bruises, as well as the best healer of the soul in cases where only the fragile sensitive nature of a child is injured. Frozen bags of cut vegetables also make great cold compresses, and a cold piece of candy or a piece of frozen juice helps with swollen lips. If the child tolerates the applied ice, begin to gradually increase the pressure; can be kept for up to twenty minutes. If you let your two-year-old hold an ice pack with his hand, he will respond more favorably to the procedure.

A quick note. In a child's life, given the repeated impacts of small heads on hard floors, brain injuries are rare.

Seizures, or convulsions, also called seizures, are caused by abnormal electrical discharges in the brain and affect not only children, but also their parents. They range in severity from twitching of one muscle to a shaking of the entire body, which is called a grand mal seizure and may also be accompanied by falling and rolling on the floor, rolling of the eyes, foaming at the mouth, biting the tongue, and temporary loss of consciousness.

Your first priority when convulsing is to prevent the tongue or secretions from blocking the airway, which will deprive the brain of oxygen. Most seizures in infancy are associated with high body temperature. Attacks of such convulsions are short-lived, stop on their own and rarely cause harm to the child, but parents can twitch for a long time after them.

If you experience seizures, do the following:

To be safe, place your baby on the floor, face down, or on his side, with the tongue hanging out and liquid flowing out of the throat by gravity.

Do not put any food or drink into your child's mouth during or immediately after a seizure; Also, you should not interfere with the child's twitching.

If your child's lips are not blue and he is breathing normally, there is no reason to worry.

Although unlikely, if your baby's lips turn blue and he is not breathing, give mouth-to-mouth resuscitation after clearing the airway.

To prevent a rushing child from hitting the furniture, clear the area around it.

After a seizure, children usually fall into a deep sleep. In addition, a small child usually has a second seizure after the first seizure within a few minutes, especially if the seizures are caused by a high temperature. To prevent this, if your child is burning up after a seizure, give him a suppository of acetaminophen (if you give the medicine by mouth, it may cause vomiting). Remove the child's clothing and cool the child's body with sponge baths.

In general, it makes sense to call a doctor immediately after the seizures stop or take the child to the emergency room. Or, depending on the circumstances, you may begin monitoring as described above in the article on head injuries. A period of observation may be worthwhile if the child felt great before the seizure, but then the temperature suddenly rose, followed by a brief attack of seizures, and now the child feels well. Keep your temperature under control and you can wait out the few hours without having to call your doctor or rush to the hospital at three in the morning. But any seizures that are not associated with a fever or that occur in a child who appears sick deserve emergency medical attention. It makes sense to use all means to reduce the temperature (give an antipyretic and cool the body) before going to the hospital, since an ever-rising temperature can cause several more attacks along the way.

Leave a lightning-fast nine-month-old baby next to a hot mug of coffee and you've got the makings of a serious burn. The severity of a burn determines how painful it is and how much it distorts tissue. A first-degree burn (such as a sunburn) causes redness of the skin, is not too painful, and requires only cold water, a soothing ointment, and time. A second-degree burn causes blistering, swelling and sloughing of the top layer of skin and is accompanied by severe pain. A third degree burn damages the deeper layers of the skin and leaves the most visible marks.

World statistics report that 80% of head injuries in children are mild concussions. Moderate bruises account for 15% of cases.

Severe skull trauma with fatal outcome occurs in 5% of cases. Traumatic brain injury (TBI) is a leading cause of childhood death and disability.

In children, death from TBI accounts for 10% of all deaths, according to some estimates.

Let's look at the types, symptoms and treatment of head and brain injuries in children. We will learn the features and consequences of birth trauma in newborn children.

Kinds

With a closed injury, there is no damage to the bones of the skull, but the soft tissues of the head may be damaged. With an open injury, the bones of the skull and soft tissues of the facial and scalp are damaged. There may be bleeding from the ears or nose.

Types of traumatic brain injury in children:

Brain contusion.
Brain concussion.
Compression of the brain with subdural hematoma;
Subarachnoid hemorrhage (under the arachnoid membrane of the brain);
Diffuse axonal damage.

Along the course, there are 3 periods of the disease:

the acute period lasts from 2 to 10 weeks;
the next period is intermediate, it lasts from 10 weeks to 6 months;
long-term period – after 6 months to 2 years and beyond.

The severity of TBI is assessed according to the following indicators:

duration of loss of consciousness at the time of the disaster;
Duration of post-traumatic amnesia (impaired memory for events preceding the trauma):
state of vital body systems;
Glasgow Coma Scale score.

Children are much more likely to have a brain injury from a head impact than adults.

The severity of brain damage is assessed by the duration of loss of consciousness. There are 4 degrees of duration of loss of consciousness:

less than 20 minutes – mild;
from 20 minutes to 6 hours – moderate degree;
between 6 and 48 hours – severe;
loss of consciousness for more than 2 days indicates severe brain damage.

Traumatic brain injury (TBI) in infants and young children most often occurs when falling from a height. The consequences of trauma in children differ from those in adults. The reaction of the tissues of the head, skull and blood vessels is different, because the bones of the skull, blood vessels and membranes of the brain in children are elastic and less damaged. Therefore, the child is less likely to experience vascular ruptures and brain contusion after injury.

Brain concussion

The consequences of a head injury in a child are manifested by general cerebral and neurological symptoms. This is expressed by signs of a concussion. After a short loss of consciousness, vegetative symptoms appear:

drowsiness and lethargy;
tearfulness;
unstable mood.

These vegetative signs persist for some time after recovery. In parallel with them, symptoms also develop:

vomiting is a common symptom of concussion in children;
moderate headache that lasts no more than 2–4 days.

Symptoms of concussion in children are reversible. In young children, it is very difficult to distinguish a concussion from a bruise.

The duration of loss of consciousness after TBI is also a diagnostic criterion. Loss of consciousness for more than 20 minutes is often a sign not of a concussion, but of a brain contusion.

TBI to the degree of brain contusion

Traumatic brain injury in children to the degree of contusion is manifested by general cerebral, focal neurological symptoms. Pinpoint petechial hemorrhages, secondary foci of ischemia and local edema form in the brain. At the same time, the capillaries of the child’s brain are overcrowded. Symptoms of brain contusion in children are diverse and variable. The diagnostic sign for the duration of loss of consciousness in children is inconsistent. Even with severe TBI, loss of consciousness may not be recorded, which is due to the characteristics of childhood.

1-2 days after a head injury, the child may have a fever

The diagnosis of brain contusion in children is made based on the following signs:

Unlike adults, children often have a fracture of the cranial vault rather than the base;
increased tendon reflexes;
horizontal nystagmus;
meningeal symptoms;
oculomotor disorders;
vomiting is a common symptom;
focal neurological symptoms.

Memory impairment is typical for school-age children after TBI. A diagnostically important sign of a brain contusion is the detection of blood in the cerebrospinal fluid.

Intracranial hematomas

With severe brain injury, subdural hematomas occur in children. Intracerebral hemorrhages develop very rarely. Symptoms of intracranial hematoma are impaired consciousness up to coma, vomiting, convulsions.

What could be the consequences?

The consequence of the acute period of severe TBI is patient disability. In the long-term period of TBI, although motor functions are restored, movement coordination remains impaired. In turn, these residual phenomena lead to a lag in physical education classes and in outdoor games with peers. As a result, the rejected child withdraws and his social skills change. And yet, in children, more often than in adults, a favorable outcome is possible even after severe brain injury due to the plasticity of brain structures.

In the long-term period of concussion, after 6 months, a complex of post-concussion syndrome develops in 30% of patients.

Signs of the syndrome:

difficulty falling asleep, unstable mood, irritability, fatigue;
periodic headaches and dizziness;
neurological examination reveals mild impairment of motor coordination;
Cognitive impairment causes many problems in the future life of young patients.

The manifestation of traumatic brain injury in children differs significantly from the symptoms characteristic of adults, and they are determined by the characteristics of the child’s body.

The cognitive consequences of TBI are manifested in changes in the personality of young patients - behavior and psycho-emotional state changes, memory deteriorates. The mood of sick children is unstable, and attacks of irritability are noted. Poor performance in school is associated with memory impairment. After a brain injury, children learn very poorly.

In the long-term period after TBI, paresis and paralysis rarely develop in children. A severe consequence of TBI is the development of post-traumatic epilepsy. After open traumatic brain injury, epilepsy develops in 50% of cases. Convulsions in epilepsy are generalized. Epilepsy rarely develops after closed TBI.

Treatment of TBI

After a TBI, the little patient is in hospital for 21 days. During this time, strict bed rest and then semi-bed rest are observed. This entire period is limited to reading and watching TV, as well as the computer. The success of treatment lies in adherence to the regimen. Drug treatment:

If breathing is impaired, the patient is connected to a ventilator (artificial lung ventilation).
When intracranial pressure increases, dehydration drugs are prescribed. However, in older children, increased intracranial hypertension is a variable sign.
For vomiting and convulsive syndrome, Aminazine and Sibazon are prescribed.
Neurovegetative blockade is indicated for severe TBI.

In case of intracranial hematoma and depressed fracture, osteoplastic craniotomy is performed. For children up to one year after removal of the hematoma, the bone area is restored through a burr hole.

Treatment in the long-term period of TBI

For a favorable prognosis, it is very important to carry out comprehensive treatment of the consequences within 1 year after TBI. Therapeutic measures include medications, physical therapy, help from a psychologist and speech therapist. To overcome cognitive impairment, nootropic vasodilating drugs are used. The use of nootropics is indicated for children who study very poorly. After a month's course of taking nootropics, memory improves, headaches decrease and movement disorders are restored.

Head trauma in a newborn child, up to a year old, usually, fortunately, passes without sad consequences

Epilepsy is treated with anticonvulsant drugs. For headaches, medications are used depending on the pathogenesis - dehydration agents (Diacarb) or vasodilator drugs.

Birth-related TBI in newborns

When a birth injury occurs in a newborn child, changes occur in the skull, membranes and brain tissue.

Causes of birth trauma:

deformed pelvis of a woman;
muscle tension of the birth canal;
malposition;
discrepancy between the baby’s skull and the woman’s pelvic bones;
large or premature fetus;
rapid or prolonged labor;
use of a vacuum extractor and obstetric forceps.

Birth trauma - damage to the tissues and organs of the child caused by mechanical forces during childbirth

The head is more often damaged when the fetus is breech. With cephalic presentation, a birth tumor occurs with swelling of the soft tissues. After using forceps and a vacuum extractor, injury to the soft tissues of the scalp more often occurs, and bone depression occurs less often. Intracranial injuries of a newborn child manifest themselves in the form of hemorrhage (hematoma) under the arachnoid or dura mater of the brain. In rare cases, cerebral hemorrhages are observed.

Extensive hemorrhages result in the death of a newborn child.

Signs of birth-related TBI in an infant

Birth head trauma is accompanied by the following symptoms:

breathing problems in a newborn baby;
strabismus;
dilation of one pupil and drooping of the eyelid;
loss of the sucking reflex of a newborn baby;
cyanosis of the skin;
muscle hypertonicity of the whole body. In this case, the bent arms and legs are pressed to the body, and the head is pulled into the shoulders.

Signs of increased intracranial pressure during TBI in a child are protrusion of the fontanel and exophthalmos.

Diagnosis of birth-related TBI

For diagnostic purposes, a puncture of the subdural space is made through the fontanel. The punctate is removed from under the dura mater of the brain on the right and left. After puncture, the condition of the newborn baby is alleviated due to a decrease in intracranial pressure.

Treatment of TBI in infants

A puncture performed in the early period of injury on days 3–5 of a newborn child’s life is curative if blood clots have not yet formed in the subdural hematoma. If blood clots form, neurosurgeons open the skull to remove the contents of the hematoma. For subarachnoid hematoma, a spinal puncture is performed daily in the first 2–3 days for therapeutic purposes to reduce intracranial hypertension. In the following days, the puncture is done every other day until the cerebrospinal fluid flows freely without pressure and 10 to 20 ml of liquid is taken.

Consequences of TBI in newborns

An unremoved hematoma after a birth injury leads to compression of brain structures with ischemia and the development of meningoencephalitis. The progression of these symptoms leads to the death of the child. If the baby does not die in the early period, irreversible organic changes occur in the brain, which lead to the following consequences:

hyperkinesis - involuntary movements of body parts;
paresis of central origin;
seizures;
mental retardation.

The consequences of birth-related TBI may not appear immediately, but may be delayed

The consequences of changes in the brain after birth trauma are manifested in the fact that as the baby grows up, he does very poorly at school. Memory impairments and developmental delays after birth trauma form a personality that is alienated from peers.

To summarize, let us recall that skull trauma in young children occurs during a fall from a height. Birth trauma varies in severity, but more often it is a subdural hematoma. The prognosis after a head injury in children is more favorable than in adults in terms of the extent of damage. But even mild head injuries in childhood have negative cognitive consequences - memory impairment, developmental delays and personality changes. Children learn poorly after a head injury.

Severe and insidious traumatic injuries to the head area occur before the age of 1 year. During this period, the baby actively explores the world around him, as a result of which the danger of falling from a height, as well as colliding with hard objects, increases. Head injuries are more often recorded among boys, due to their inquisitiveness and hyperactivity.

In addition, head injuries in children of the first year of life are caused by the anatomical features of their body structure. In young children, compared to other parts of the body, the head has more weight, as a result of which, when losing balance, the entire blow falls on the forehead or back of the head.

Causes

A child under 1 year old can get a head injury at home or while walking outside. Loss of parental vigilance, as well as highly traumatic environmental conditions, contribute to an increased risk of injury. A child under 1 year of age can injure the head area under the following conditions:

If you fall from a changing table, sofa or parent's bed. At this age, children are very hyperactive, so a momentary loss of parental vigilance leads to the fact that the baby can fall onto a hard surface from a height when turning or suddenly moving his legs;
If the baby makes his first attempts to walk, then loss of balance often leads to falls and hitting his head on the floor or hard objects;
If you fall out of a highchair, crib or stroller. A short-term loss of maternal vigilance often results in the fact that, against the background of sudden movements of the limbs, the baby loses his balance and falls, hitting his head.

Small children tend to fall forward, so the frontal and parietal areas of the head are more likely to be hit. Such injuries are very dangerous for the child’s health, so it is important for the baby’s parents not to lose vigilance and closely monitor his behavior.

When a child hits a hard surface with his head, the following traumatic brain injuries can develop:

Diffuse axonal disorder;
Shake;
Contusion of the brain substance of varying severity;
Violation of the integrity of the bone elements of the cranial vault;
Crush of brain matter;
One type of hematoma (subarachnoid, epidural or subdural).

Symptoms

In order to understand the degree of head injury when a child under 1 year falls, parents should pay attention to the following signs:

Was there an interval between the fall and the baby's cry? If there was such a pause, then this indicates a short-term loss of consciousness after hitting the head;
Next, you should examine the area of impact, paying attention to the presence and nature of the wound, as well as the symmetry of the head. If a child falls and injures soft tissue, the damaged area turns red and becomes swollen. Along with the listed symptoms, bleeding of varying degrees of intensity is observed when soft tissue ruptures. If the integrity of the bone elements of the head was damaged during the blow, then parents may notice an asymmetry of the skull, as well as the release of a clear liquid (CSF) from the wound surface.

The following additional symptoms indicate the development of a head injury:

Lethargy of the baby or increased emotional excitability;
Strong and prolonged crying;
Paleness of the skin;
Drowsiness;
Refusal to feed;
Changing the size of the baby's pupils.

In addition to the listed symptoms, parents need to pay attention to the muscle tone of the child’s upper and lower extremities, which is often reduced with head injuries.

First aid

The reason to contact a medical specialist is any fall that is accompanied by hitting your head on a hard object or surface. If parents notice one or more of the listed symptoms, then they need to immediately call an ambulance or take the child to the emergency room themselves. Those kids who hit their head as a result of a fall need to consult a traumatologist, neurologist and, if necessary, a neurosurgeon.

For diagnostic purposes, not only an examination of the child’s head and entire body is performed, but also studies such as radiography and neurosonogram (ultrasound examination of the brain). In order not to worsen the general condition of the child, it is strictly forbidden to independently provide assistance to the baby at home. It is also prohibited to independently choose medications and their dosage.

Consequences

Hitting your head on a hard surface when falling is equally dangerous for people of any age, especially if we are talking about babies under the age of 1 year. When, as a result of an injury, a child develops one of the types of hematomas, this neoplasm exerts mechanical pressure on the structures of the brain, causing ischemia and meningoencephalitis. In especially severe cases, the situation can be fatal. Other common consequences of hitting the head before the age of 1 year include:

Delayed psycho-emotional development in the future;
Involuntary sudden movements of individual parts of the body (hyperkinesis);
Convulsive syndrome;
Paresis of central origin;
Loss of coordination;
Dizziness;
Increased intracranial pressure;
Epileptic seizures.

The brain has a complex structure, so the consequences of a head injury can be unpredictable. If, as a result of an injury, the integrity of the skin is compromised, then the risk of pathogenic microorganisms entering the baby increases, followed by hematogenous and lymphogenous distribution throughout the body.

Regardless of whether or not there are signs of traumatic injury to the head area as a result of a fall, parents need to immediately show the child to a medical specialist, since some head injuries have a hidden course, leading to serious consequences.