The child fell from the pot and hit his head. What to do if a child falls and bumps his head? Recommendations for parents from a pediatric neurologist

29.08.2019

What if the child bumps his head? This question worries many moms and dads. All parents, even the most experienced and attentive, face the problem of childhood injuries. Small children, in particular toddlers who have just learned to walk, quite often frighten adults with their unexpected falls. One has only to be distracted for a moment, as the crumb already conquers the next "peak" in the form of a chair or sofa. But for children who still do not know how to move independently, their favorite pastime is rolling from back to stomach and vice versa. It is good if all these movements of the baby do not pose a danger to his health. Despite all the safety measures taken, sometimes there are blows and falls, not a single child can do without them. It is most dangerous when the baby falls and hits his head. What if a child hits his head? What should be the priority actions of adults? This situation requires a sober assessment of the situation and immediate decision-making.

What if a child hits his head? Inspect the impact site.

Small children very often hit their heads during a fall, since they still do not know how to maintain balance and control their body. The most dangerous consequences of a head injury are concussion, contusion of the brain and fracture of the bones of the skull.

What if the child hits his head? The main thing is not to panic and try to calm down the already frightened crumbs. Here, your composure is required to adequately assess the general condition of the baby and examine the impact site. The first thing to do if a child hits his head is to examine the head for visible damage. It can be a bruise, "bump", abrasion or dissection of the soft tissues of the head, it all depends on the force of the impact and the surface on which the baby fell. If he stumbled while walking and landed on the soft carpet, the most that can appear is a "bump" on his forehead. It is quite another matter when, instead of a carpet, there is a solid tile, on which the crumb raced with extraordinary speed.

1. What to do if the child hits his head and a "bump" or bruise (hematoma) appears?

Apply a cold compress, of course. Any water bottle, vegetable, or fruit from the refrigerator will work for this. Despite the baby's resistance, it is necessary to hold the compress for at least a few minutes to reduce the swelling and prevent further spread of the hematoma.

2. What if the child bumps his head and is bleeding from the abrasion?

You need to stop the blood with a cotton swab. In any home with small children, you can find hydrogen peroxide in the medicine cabinet. Dampen a cotton swab with it and wipe the abrasion to avoid infection. If the bleeding does not stop within 10 minutes, you should immediately consult a doctor. In this case, it is best to call an ambulance.

During the fall, the baby could hit not only his head, so carefully examine him for bruises and fractures. Older children can themselves point out the place that hurts. Even if the baby complains of pain, no pain relievers should be given before the doctor arrives, as they can blur the clinical picture and complicate the diagnosis.

What if a child hits his head? General condition is assessed.

1. What if the child hits his head and there is no visible damage?

Contrary to the irresistible desire of the mother to run somewhere and do something, you just need to carefully observe the child's behavior. In order for the assessment of the condition to be objective, in the first half hour after the injury, do not let the baby sleep, because if he falls asleep, you can lose sight of the alarming symptoms of a brain injury.

2. What if the child bumps his head and faints?

Loss of consciousness, dizziness and vomiting are the main signs of a concussion, in the presence of which, you must immediately call an ambulance. Is the kid unconscious? So, first of all, a child who has hit his head must be laid on its side, that is, to give the body a "safe position" so that it does not choke on vomit. While the ambulance is on the way, check the presence of breathing and pulse, assess the condition of the pupils. In severe brain injuries, pupils can vary in size. If the baby is not breathing, give mouth-to-mouth resuscitation.

What if the child bumps his head? Alarming symptoms.

It is imperative to call an ambulance if the child hits his head and the following alarming symptoms appear:

deterioration in general health;
cry for more than 15 minutes;
dizziness, drowsiness, weakness, loss of consciousness;
the appearance of seizures, loss of sensitivity, paralysis of the limbs;
nausea, vomiting, blood in the vomit;
profuse bleeding from the wound;
clear discharge from the nose, mouth, or ears;
hemorrhage in the eye.

What if a child hits his head? They continue to observe.

When you have completed all that you are doing, if the child bumps his head, and all the dangerous symptoms of a brain injury are absent, continue to observe the behavior of the crumbs. Older children can be asked a question and, according to the adequacy of the answer, assess the degree of brain damage. Even at night, you need to wake up the child and check his health. Monitoring the condition of the crumbs must be continued for 7-9 days. That, in principle, is all that is done if a child hits his head.

Good day to all! I propose to dispense with long prefaces today. A head injury to a toddler is too serious a situation.

If a child hits his head, what should he pay attention to so that trouble does not happen? Now I’ll tell you everything.

Ksenia Remizova, a neurologist, a mother of two children, helped me write this article. She shared her own story:

“When my youngest son was 10 months old, he managed to fall out of the chair. The child was in the kitchen with dad. The husband turned away for a moment to put a dirty plate in the sink - and at that time the son got up and rolled over the back. He fell headlong on the hard floor. The kid was crying, I was in a panic. We called an ambulance.

Until we got to the emergency room, my son calmed down. He slept a little, then woke up, looked at the new place with interest, smiled ... We hoped that everything worked out. What was our horror when a child was found to have a fracture of the parietal bone!

Then there was treatment in the children's neurosurgical department, observation by a neurologist in a polyclinic ... Now my son is almost 3 years old. He has no consequences of the injury. "

My child also has a history of trauma; at the age of 2, 10, he jumped on the bed, and jumped into my ... knee. I myself was in great pain, and the child did not even cry. I limped all day and was surprised that my son didn't even have a lump, and he was cheerful and cheerful.

Unfortunately, the next morning, the consequences began - he lost his orientation in space, he could not be pushed, he could not focus, looking at me, plus there was vomiting. It was terrible for me, I was very scared, and we had to go to the hospital. They got a concussion, it's good that everything recovered pretty quickly.

From these stories, I want to draw your attention to two points:

Head injuries can be insidious.

Children recover well. They can even endure severe head injuries without consequences.

Let's take a look at the dangers of a head injury.

Blow to the head: options for the development of events

Option 1, happy - everything worked out

Let's say a kid, running, hit the wall. My head ached a little - and everything was gone. The only memory of the injury is a lump on the forehead.

Option two, concussion

From the blow, the brain cells stopped working normally for a while. The headache persists, and vomiting may occur. The head is spinning, vomiting is possible.

Option three, brain contusion

The blow was so strong that a part of the brain was damaged. The head hurts, the child is vomiting, the head is spinning. Speech or coordination may be impaired.

Option four, the most dangerous - hemorrhage into the cranial cavity

This situation is urgent. Blood is the extra volume inside the cramped cranium. If it doesn't stop, it can compress the brain. This can lead to death from cardiac or respiratory arrest. Ambulance immediately!

Head injury - how to react?

So the child hit his head hard. What to do in such a situation? The UN formula will help you. Look here:

Stop bleeding
Limit activity
Observe

Let's understand it thoroughly.

Obleed

To do this, attach any frozen food from the freezer to the injury site. The best thing is something free-flowing. This "ice pack" will easily take the shape of the head. Just wrap it in a towel.

Rinse the wound with hydrogen peroxide. Apply a bandage.

Consider this:

A wound wider than 0.7 cm and longer than 2 cm requires suturing. See your doctor!

Olimit activity

During the day after the injury, all active games are contraindicated for the baby. It is also better not to watch TV, and not to read books on your own.

Let him lie in bed and listen to audiobooks. You can draw, play board games ... You know better what to do with your child.

The day after the injury, do not send the "victim" to school or daycare. Let him stay at home, under the supervision of relatives.

So we got to the most important point:

Nto observe

From what height did the baby fall? When?
What did he hit?
Did you lose consciousness?
How many times did you vomit?
What did you complain about?
How did you behave after the injury?

Keep your eyes on the baby for 24 hours after the injury. If he sleeps, wake him up every three hours, day and night, to make sure he's okay. To do this, ask some elementary question, and let the baby answer you. Did he answer correctly? Is it ordinary? Let him sleep on.

Keep in mind that it happens that the consequences of a bruise can begin on the second or third day. Therefore, the first three days require your attention to the child's condition.

Red flags for head injuries

Finally, I will list the symptoms of severe trauma, "red flags", as doctors say.

If you see THIS - call the ambulance immediately!

Impaired consciousness. You cannot wake up the baby. Or he is sluggish and has difficulty answering questions.
Change in speech. Slow speech, stuttering. The little child stopped talking.
Great drowsiness.
Behavior change. The child is "somehow not like that" for no apparent reason.
Headache for more than an hour after injury.
Vomiting more than once.
Dizziness for more than an hour after injury.
Disorder of coordination: the child is "like a drunk", he is "carried over".
Convulsions - twitching of the arm, leg. Or the baby suddenly loses consciousness and “shakes” him.
Weakness in an arm or leg. An adult child limps, cannot walk on tiptoes, complains of awkwardness in an arm or leg. The baby cannot lean on the handle when crawling, cannot lift one leg when lying on its back.
Different pupils.
Symmetrical bruising under the eyes or behind the ears.
A colorless or bloody fluid comes out of the nose or ear.

Brr! I wish you do not find any of these signs in children.

Doctor Komarovsky once said: "I have not seen a single child who would have lived up to a year and did not fall off the couch." Children had, are and will have head injuries. But it is important to assess the situation correctly and consult a doctor in time.

Now you know what to do , if the child hits his head. In order not to lose important information, post the article on social networks. You will always have it at hand - and it can be useful to your friends!

I wish you and your children health, joy - and no injuries!

Hug

yours Anastasia Smolinets.

All babies are very mobile, so various bumps and abrasions are normal for them. In most cases, their fall occurs upside down. Nature has taken care of the protection of the child's brain, therefore, basically, such blows are not able to cause significant harm to the baby. Although there are injuries that pose a danger to the baby. If a child hits his head, what should adults do in this case?

Danger of head bumps

As soon as the baby has learned to move independently, he often falls, and bumps appear on his head. Parents, as a rule, do not pay attention to this, considering this condition to be normal. How do you know if it's worth worrying?

Forehead blow

The consequence of the fact that the child fell upside down, hitting his forehead, is the appearance of a bump. This is due to trauma to small vessels and the filling of surrounding tissues with blood. The result is edema and hematoma. Due to the fact that the bones of the forehead are quite strong, these injuries are not dangerous. But, if a bump after a fall appeared in a baby, then it must be shown to a doctor who can determine the degree of damage and exclude serious consequences.

Back of the head

Sometimes, the child may fall on his back and hit the back of his head. In this case, parents should hurry to the doctor. This is due to the fact that such injuries become the cause of serious problems in the future. Due to the fact that nerve endings are located in the back of the head, affecting the work of the organs of vision, it can be disrupted. The child is able to lose consciousness, he has tremors in his legs and general weakness of the body. And all this can be even with a small bump.

Seeing that the child hit the back of the head, hurry up with him to the doctor, even if he does not present any complaints. There are times when signs of such injuries can appear over a long period of time.

First aid

Falls and shocks are common for children, especially one-year-olds, so you always need to know what to do if the child hits his head hard. Correct and timely action will help prevent the development of severe consequences of injury. First, the damaged area must be carefully examined. Adults should try to determine the severity of the blow, regardless of where it hit (forehead, back of head or temple):

The appearance of a hematoma in the place where the blow occurred. Apply cold (ice) to the place of edema as soon as possible. A bottle filled with cold water or a handkerchief soaked in water will also work. It is necessary to hold such a compress for about 5 minutes in order to alleviate the condition and reduce the swelling of the affected tissues.
After the fall, there was an abrasion and blood appeared. The wound must be treated with hydrogen peroxide. This will keep various pathogens from getting through the wound. If you are having trouble stopping the bleeding right away, call an ambulance.
The kid could have hit, but there is no damage in this place. Parents should watch him closely for several more days, noting any deviations from the norm in his behavior or condition. The child may feel a headache or dizziness, become moody and irritable, sleep for a long time or get tired quickly. All this may indicate a concussion or some other serious injury. Noticing a sharp deterioration in his condition, loss of consciousness, the occurrence of nausea and vomiting, it is necessary to urgently call a doctor.

Adults should reassure the child and provide complete peace of mind. To do this, it is better to put the baby in bed, read a fairy tale, explain that nothing dangerous has happened and after a rest he will be able to play again.

In this case, the main thing is to do everything so that he is awake for several hours, because many of them immediately begin to fall asleep. This is done in order not to miss serious symptoms and to identify the severity of the injury.

Doctors recommend waking your baby up at night to check coordination. After a few days, if he continues to feel good and is not bothered by anything, then the parents can calm down. In the first time after the injury, he should spend more time walking on the street, but avoid active pastime.

Alarming symptoms

Each toddler can fall to the floor or bump his head on furniture or any other object. If this happens, the parents should track him down. At the same time, any physical activity should be minimized. Older children need to limit their brain activity - not reading, playing on the computer or watching TV. A child who complains of weakness or dizziness should be seen by a doctor.

After hitting the forehead

Children can often bump their foreheads. A visit to the doctor cannot be postponed if the parents notice:

In the place where the bump was, a depression formed.
The kid complains of nausea, vomiting has appeared.
Cannot calm down for a long time.
The lips turned blue and the skin was pale.

Tatyana Gurevich, head of the Movement Disorders Clinic at the Tel Aviv Medical Center, talks in detail about head injuries:

The pupils are greatly enlarged or squint appears.
Too big a bump appeared at the impact site.
He cannot turn his head to the side, it is difficult for him to move.
There is bleeding from the nose or ears.

If at least one of the above signs is noticed, you need to immediately show the child to a doctor. Even in the case when it seems to adults that the injury is insignificant, consultation with a pediatrician is required!

Before the arrival of the doctor, the victim should not be given medications, so that the doctor can assess the real picture of the damage. The baby should be lying on its side to wait for the examination.

After hitting with the back of your head

If the blow hits the back of the head, the symptoms that should alert you will be almost identical. Additionally, numbness of the extremities, loss of consciousness (may be prolonged), visual impairment (blurred, complete absence, etc.), tinnitus, severe dizziness, impaired coordination of movements and memory loss may appear.

Such blows are often the cause of concussion. And even if the baby just flopped to the floor, hitting the back of the head, this state cannot be ignored. To avoid negative consequences, it is better to show the child to the doctor immediately.

Older children and adolescents can be injured if they fall on their backs while rollerblading, cycling, or in a fight. To avoid trouble, it is important to teach your baby how to fall correctly as early as possible, and when riding a bike, you must use a protective helmet.

Possible consequences

Children can fall in any direction. The type of injury, signs and consequences will depend on where the blow fell. Even if the child seems healthy, adults still need to observe his condition and behavior for several days.

It is possible that the state of health will begin to deteriorate after a while. Children may complain of headaches, memory problems. They become moody, sleep and appetite are disturbed.

On a forehead bump

Children can fall forward and hit their foreheads most often. In such situations, the simplest manifestation of injury is a lump. There are 2 types of traumatic brain injury:

Closed - without violating the integrity of the bones of the skull and skin. Separate light (not threatening the baby) and complex injuries (when treatment is necessary).

Open - damage to the skin and bone occurs. As a result of the fall, the baby's consciousness is disturbed and bleeding appears.

Neurologist M. M. Shperling talks about traumatic brain injury. We listen to the doctor:

Closed include the following injuries:

Brain concussion. The victim may lose consciousness (this usually lasts a few minutes). After that, dizziness, nausea and vomiting will appear. Pale skin and blue lips are observed. Although, it is possible that the child will not have any signs of a concussion. But it's too early to rejoice. Parents in such situations should analyze the behavior of the baby during sleep. With a concussion, sleep is disturbed, he often wakes up. If this is the case with your child, then it should be shown to the doctor. If the diagnosis is confirmed, the child needs bed rest.

Brain contusion. In this case, after the blow, the children lose consciousness. The skin around the eyes darkens and blood may come from the ears and nose. In this case, you need to call an ambulance. Other signs of brain injury include: impaired speech and facial expressions, damage to the facial nerve.
Contusion of soft tissues. This injury is the easiest and most harmless. In this case, a lump or hematoma appears at the site of the impact. The child quickly calms down and his condition returns to normal.

Consequences of a blow to the head

On impact with the back of the head

Falling on the back of your head is very dangerous. Therefore, after such an injury, the baby should be immediately shown to the doctor in order to avoid serious consequences:

Perceptual impairment. When the blow came from the left side, the baby may not perceive the space that is on the left and vice versa. This condition is considered very serious and dangerous, but it is rarely diagnosed.
Children can become inattentive. Sleep is disturbed, memory deteriorates. The kid is tormented by constant headaches.

Doctor Komarovsky talks about childhood head injuries and when it is necessary to urgently consult a doctor:

Such consequences can be avoided by showing the child to a doctor as soon as possible after the injury.

Injury prevention

Any fall can result in a blow to the head. To avoid this, young children should not be left unattended by adults, wherever they are (on the couch, changing table, in the crib or stroller). They may roll over or try to crawl, as a result of which they may fall and bump. If you need to leave the room where the baby is, place him in a playpen or lay him on the floor where it will be safe for him.

While changing the crumbs, hold it with your free hand. When the child is sitting on the bed, even if you are nearby at the time, place some pillows on the floor. Children are incredibly mobile and it is not always possible to keep track of them.

Safety precautions must not be neglected when walking in a wheelchair. When choosing a stroller, pay attention to models with high sides. And when seating a child there, be sure to fasten him with seat belts.

Children who are learning to walk especially often fall. At this time, their legs are not yet strong enough and it is easy for him to stumble or slip. To make the baby comfortable, put on socks with special rubber inserts on the feet, which will prevent him from sliding on the floor. It is equally important to protect the surrounding objects and furniture. Silicone pads are sold especially for sharp corners. Parents can also cover these areas with a soft cloth.

While descending the stairs, you need to firmly hold the children's handle, as the baby can easily slip when falling down. And this is extremely dangerous. One of the most traumatic places for children is the playground. To prevent injury in babies, parents should always be with them. This is especially true for swinging or playing on high structures.

For older toddlers who begin rollerblading or cycling, always wear a safety helmet, which can always protect the baby head from injury in the event of a fall. For children who go in for sports, it is important to learn how to fall correctly and group at the same time.

The head is not only the most important, but also the most vulnerable part of the human body. Therefore, she needs a careful attitude. The main task of adults is to monitor the baby and in a conversation with an older child, during which he needs to explain the importance of safety at home. If, nevertheless, it happened that the child fell and hit his head, he must be shown to a doctor in order to exclude the occurrence of serious injuries.

The brain, the holy of holies of the body, seems to be firmly protected by the bones of the skull. But it is the cranium in trauma that most often causes brain damage. As you know, between the bones of the skull and the brain are the meninges and a special fluid - the cerebrospinal fluid, which additionally protects the brain. During a head blow, the brain continues to move by inertia, that is, it moves inside the cranium, sharply bumping into the bones of the skull. Liquor extinguishes this movement, but not always. And in case of severe injury, if there are bones of the skull, fragments of bones can damage the brain.

A child's skull is an even more fragile and vulnerable structure. Children are much more likely to have brain injury from head impacts than adults. Especially in the first year of life, when the bones of the skull have not yet grown together and are easily displaced upon impact.

Adults are obliged to know where the baby is in danger. Falling to the floor from the changing table or falling out of the stroller is a "hobby" for babies. Older children master the world, testing it for strength with their own foreheads. The young traveler does not even need sharp corners - he will fill a bump literally out of the blue. And it's good if the bump. And when the baby grows up and starts running, it is not known who clutches his head more often - a terrified mother or himself.

Alas, it is impossible to completely protect the child from injury. If yours falls rarely, do you tremble too much over it? According to the excellent pediatrician Benjamin Spock, "it will save his bones, but spoil his character."

How can you and I, if not protect the baby, then at least reduce the risk of head injury?

Babies up to a year

Babies most often roll to the floor from the changing tables, so you need to swaddle your baby not on the table, but, for example, on the sofa. It is lower. Also, to cushion a possible fall, place a rug under a table or next to a sofa. Three more simple recommendations:

do not take your eyes off the baby for a second while changing;
try to hold it with your hand;
if you need to go away (for a bottle, or pick up the phone, or open the door), take your baby with you. Otherwise, he may at any time roll over from his back to his stomach (it is better not to think about the consequences of such an acrobatic etude).

You have to keep an eye on the baby even when he lies quietly in his crib. However, lying is half the battle. As soon as he starts to sit down, keep an eye on both. If your fidget has already mastered the art of sitting, urgently purchase a low, stroller. And necessarily mobile, that is, one in which it can sit and lie. It is more difficult for him to get out of such a wheelchair, and it is safer to fall.

The kid has grown

Special socks with "brakes" (these are rubberized inserts in the sole of the sock that reduce slipping) can protect the child from falling in the apartment. They are especially useful in an apartment with parquet flooring. Place rugs in places where your baby's usual routes are (but so that they lie snugly and do not slip on the floor). For the first time, wrap sharp corners near furniture, door frames with some dense fabric. Remove ya and other furniture from the windows - this will keep the inquisitive person from the desire to climb onto the windowsill or, scary to think, open the window.

And if all the same ...

Bleeding can also be stopped by applying a dense piece of dry cloth (tampon) to the wound. If it is soaked in blood, place a second over the first swab. Attention! If it continues after 15 minutes, call a doctor immediately.

After any head injury, the child needs rest, but do not let him fall asleep for an hour, otherwise you will not understand how difficult his condition is. Wake your baby up at night. If he does not answer simple questions, or his coordination of movements is impaired, or vomiting is repeated, urgently call a doctor. Pay attention to pupils: their uneven size indicates severe brain damage. If you suspect a serious injury, and the baby is asleep, do not wait until he wakes up: call a doctor.

Typical cases of infants with craniocerebral trauma

The baby is lying on the changing table or on the couch, mom turns away for a few moments and falls on the pop.
The crumb is left unattended in a high place. He kicks off the table with his feet and falls onto his back with the bump.
The kid tries to get up in the crib. Something on the floor piqued his interest, and he hangs over the side and falls.
The baby was left to sit in the carriage, not assuming that he would try to get up in it and, not finding support, would fall down.

External manifestations of head injuries

Since the relative weight of the baby's head is much greater than the weight of the body, then when falling, he first of all hits his head and, more often, the parietal region. Very rarely, the frontal and occipital regions of the head are injured.

After a fall, the child develops redness in the impact zone, and the child feels pain. If, for several minutes, a pronounced rapidly growing edema does not appear in this place, but only slight swelling is noted, then this usually indicates contusion of the soft tissues of the head(which does not apply to TBI). Something cold must be applied to the sore spot (a bubble of ice, a towel moistened with cold water - do not forget to wet it periodically, etc.). A cold compress is applied for at least 5-15 minutes (or at least for that time, how much the baby will allow to do - often such a procedure causes an active protest). A cold compress will reduce tissue swelling, which interferes with the normal functioning of the organ, narrowing blood vessels, which is the prevention of bleeding and will become an important factor in the favorable outcome of the injury in the future. The advantages of this procedure are more weighty than the mythical possibility of hypothermia of a child within such a short period. Most importantly, stay calm and try to calm your child down.

Outward signs of concussion in children of the first year of life are rather scarce. For infants, loss of consciousness against the background of a concussion is very rare, in contrast to children of preschool and school age and adults. They also cannot complain of a headache. They just immediately start crying loudly, motor restlessness arises. After screaming, they can fall asleep. Waking up, they are capricious, refuse food. Then vomiting (usually single) or frequent vomiting appears. On the first night after the injury, they do not sleep well. The more pronounced these violations in the child's behavior and the longer they are, the more likely a concussion is.

Another reaction to trauma is possible: after sleeping, the child's external signs of trauma disappear and a false idea of recovery is created. This is a dangerous misconception: the baby's condition can deteriorate sharply.

If after the fall there was a long period of time (from one to several minutes) between the fall itself and the baby's cry from the impact, most likely there was a loss of consciousness. The presence of such signs often indicates bruised brain... But sometimes in such a situation, parents lose track of time, it is difficult for them to navigate, a lot of time has passed since the child's fall or not enough, whether there was a loss of consciousness or not. Even if he just started screaming from the blow, but before that it was quiet for some time, this situation should alert the parents, and it should be attributed to a more severe pathology. This will allow you, without wasting time, to seek medical help and find out the severity of the injury. Brain contusion is accompanied by impaired blood flow of varying severity (from decrease to complete cessation), edema of the brain substance, cerebral hemorrhages, possibly paresis2 and paralysis3. Other signs of pathology are the same as during a concussion, but only more pronounced: repeated vomiting, prolonged anxiety, etc. In severe brain bruises, a coma develops4.

2Paresis (from the Greek paresis - weakening, relaxation) - a decrease in the strength and / or amplitude of voluntary movements due to a violation of the transmission of nerve impulses to the corresponding muscles.

3 Paralysis (from the Greek paralyo - to untie, relax) is a disorder of motor function in the form of a complete absence of voluntary movements due to impaired transmission of nerve impulses to the corresponding muscles.

4Koma (from the Greek. Koma - deep sleep; synonym for coma) is a state of deep depression of the functions of the central nervous system, characterized by complete loss of consciousness, loss of response to stimuli and dysregulation of vital body functions.

If a hemorrhage occurs in its substance during a brain injury, this leads to compression of the brain, which may damage the vital centers of respiration and cardiac activity, which disrupts their functioning until the complete cessation of the body's vital activity. As a rule, in children with intracranial hemorrhages, depression of consciousness is noted. The degree of impairment of consciousness can be different depending on the degree of brain damage - from severe drowsiness to coma.

Children who fall from a height may have skull bones (open TBI), which can also compress the brain. Skull fractures in infants are most often defined as fractures, so-called linear fractures. By their localization, length, width, one can judge the severity of the injury. So, the divergence of the edges of the bone and may indicate that there is a rupture of the dura mater, and this is an indication for surgery. Depressions (dents) are more rare. In this case, the bone is concave inside the skull, bone fragments squeeze the brain. They also require surgery. In zone a, a rapidly growing edema appears, which may be the result of blood accumulation in soft tissues (hematoma) due to damage to them by bone fragments. Often, it is the presence of such edema (bumps) on the child's head that makes the parents consult a doctor, while the very moment of injury or its other consequences are unnoticed.

What to do first if you fall

We strongly advise parents who have suffered a head injury: even if, in your opinion, nothing bothers the baby, he fell from an insignificant height, stopped crying, etc., immediately seek help from the following doctors: pediatric neurologist, traumatologist, neurosurgeon... To do this, you need to call an ambulance team at home and you and your child will be taken to a specialized hospital. Alternatively, go to the admission surgery department of any large children's hospital on your own, where the specified specialists will consult the child. If they do not confirm the pathology, you can safely return home.

Failure to see a doctor is dangerous due to late diagnosis of trauma, aggravation of the child's condition, and the possibility of coma. All this requires treatment in intensive care, in some cases - surgery. A late visit to a doctor increases the risk of death, complications, lengthens the recovery period and worsens its outcome, up to the point that you may become disabled.

Where is TBI treated?

According to the existing rules (standards), everyone with traumatic brain injury should be hospitalized. Children with a concussion (mild traumatic brain injury) can be treated in a neurological and neurosurgical unit. Patients with more severe trauma should be treated in a neurosurgical unit (if available in the specific region).

Carrying out grounded, targeted treatment requires a comprehensive examination of the child, which is possible only in a hospital.

This includes thorough studies of the nervous system, vestibular apparatus, organs of vision, hearing and other studies.

In the admission department, the child is examined, signs of damage to the bones of the skull or brain injury are detected, parents are asked about the child's condition after a fall, etc.

Methods for diagnosing TBI

An important aspect of head injury in infants is neurosonography-examination of the structure of the brain using an ultrasound apparatus through the large fontanelle of the child (such a study is possible until the large fontanelle is closed, up to 1 - 1.5 years). This method is easy to use, does not have a negative effect on the body, and provides enough information to determine the tactics of treating a patient. With its help, it is possible, first of all, to exclude or determine the presence of intracranial hemorrhages (the most dangerous for life). The only limitation of its use may be the absence of an ultrasound machine or a specialist who can work on it in the hospital (for example, not in all hospitals in the country that have ultrasound machines, it is possible to perform emergency neurosonography at night, since the specialist works during the day).

If intracranial hemorrhage is suspected (especially if, for various reasons, it is not possible to do neurosonography), a lumbar puncture is performed - a therapeutic and diagnostic manipulation, in which a hollow needle connected to a syringe is punctured in the region of the second or fourth lumbar vertebrae of one of the spaces of the spinal cord (subarachnoid space) and taking a portion of the cerebrospinal fluid for examination under a microscope. By the presence of blood cells in the cerebrospinal fluid, the presence of intracranial hemorrhage is judged.

In addition, there are more sophisticated methods for examining a child's head: computed tomography (CT) and magnetic resonance imaging (MRI).

Computed tomography (CT)(from the Greek tomos - segment, layer + Greek grapho - to write, to depict) - a research method in which images of a certain layer (cut) of the human body (for example, the head) are obtained using X-rays. During CT, the rays fall on a special device that transmits information to a computer, which processes the received data on the absorption of X-rays by the human body and displays the image on the monitor screen. Thus, the smallest changes in the absorption of rays are recorded, which in turn allows you to see what is not visible on a conventional X-ray. It should be noted that the radiation exposure with CT is significantly lower than with conventional X-ray examination.

Magnetic resonance imaging (MRI)- a diagnostic method (not related to X-ray radiation), which allows one to obtain a layer-by-layer image of organs in various planes, to construct a three-dimensional reconstruction of the area under study. It is based on the ability of some atomic nuclei, when placed in a magnetic field, to absorb energy in the radio frequency range and emit it after the termination of the radio frequency pulse. For MRI, various pulse sequences of images of the structures under study have been developed to obtain optimal contrast between normal and altered tissues. This is one of the most informative and harmless diagnostic methods.

But the widespread use of CT and MRI and early childhood is difficult due to the need to carry out this in children in a state of immobility (under anesthesia), since an important condition for the successful implementation of the technique is the immobility of the patient, which cannot be achieved from an infant.

TBI treatment tactics

After the examination and clarification of the diagnosis, the treatment tactics are determined. Prescribed medication (therapy aimed at eliminating cerebral edema, lowering intracranial pressure, correcting metabolism and blood flow in the brain, etc.). Surgical treatment is used (and necessary) primarily to eliminate brain compression. It is prescribed for children with depressed skull bones and intracranial hemorrhages.

Parents need to realize that only a comprehensive, adequate child allows them to correctly and timely conduct brain injuries, achieve recovery and avoid disability.

Consequences of TBI

Research on traumatic brain injury suggests that even mild trauma can have undesirable consequences.

Under the influence of trauma (the moment of mechanical damage to the brain substance) and its consequences, the functions of various parts of the brain are disrupted, and, consequently, the work of subordinate organs and systems (endocrine, digestive systems, etc.). Blood flow may be impaired, including the outflow of venous blood from the cranial cavity. The regulation of vascular tone suffers - they can inadequately narrow, leading to an increase in blood pressure. All this impairs the course of metabolic processes in the brain, as a result of which the brain cells can be replaced by cystic cavities, that is, holes filled with fluid are formed in their place, and in the place where these cysts are, certain brain functions drop out. For example, the frontal lobes are responsible for intelligence, which means that the presence of cysts in this place reduces it. In addition, it is known that the brain normally has spaces inside and outside filled with cerebral (cerebrospinal) fluid. After injury, it can accumulate excessively in them - and therefore, intracranial pressure increases. The fluid under pressure compresses the substance of the brain, causing it to slowly atrophy5 (this phenomenon can also occur with the formation of cysts).

The launch of the pathological mechanisms of trauma depends on its severity: the more severe it is, the more pronounced the impairment, the worse the outcomes, and the longer the recovery period.

5 Atrophy (from the Greek atrophia; a - absence of a sign or quality, trophe -) - a decrease in the mass and volume of an organ or tissue as a result of an eating disorder, accompanied by a weakening or termination of their functions.

In mild traumatic brain injury, the prognosis is usually good, provided that the recommended regimen and treatment are followed. After recovery, asthenization phenomena are possible - he quickly gets tired, becomes inattentive, irritable. In this case, the baby is more inhibited, which can lead to repeated injuries. These phenomena can affect in the future and on the intellectual development of the child.

In case of moderate TBI, an increase in intracranial pressure, frequent headaches, and impaired coordination may join the asthenization phenomena.

In severe TBI, the prognosis may be unfavorable - mortality in these cases reaches 15-30%. After recovery, a wide variety of consequences are possible: from varying degrees of movement disorders, pronounced convulsive seizures to gross disorders of the psyche, consciousness, which leads to disability.

With an open head injury, purulent-inflammatory complications often occur (for example, meningitis - inflammation of the meninges of the brain, etc.), which can also be fatal.

There is still no clear answer to the question of how long it takes for the body to fully recover even after a mild TBI. It was believed that after such an injury, recovery occurs within a few days, a maximum of 2-3 weeks. But studies have shown that 1-3 months after a concussion, at least half of the children have some deviations from the norm, which sometimes persist for a longer time. The speed of recovery depends primarily on the severity of the injury, the age and previous health of the child.

Among the various injuries to the body, head injuries account for 30-50% of all injuries in children. And this figure is increasing by 2% every year.

How to reduce the likelihood of TBI

Traumas in children happen most often in the presence of adults, and this once again testifies to our carelessness or frivolity and carelessness, as well as the fact that we have a poor idea of the baby's motor skills. Parents should anticipate new motor skills in their child and take safety measures.

So, a month, lying on his stomach, can push off with his feet from the side of the changing table, from the back of the sofa, bed and fall. Each next skill or movement of the baby (attempts to sit, crawl, stand) can also lead to "unexpected" injuries. A child, trying to get up, may fall out of the stroller, out of the child's seat, especially if they forgot to fasten it.

If you need to move away, do not leave the baby alone lying on any high (and not so) surface, put the baby in a crib, playpen or even on the floor.

Headache in children

Many people think that headache is an attribute of old age. However, in the last from time to time more and more often suffer from it, especially in adolescence. Understanding why a child has a headache is not easy at all. In search of the truth, the doctor sends such a patient to a neurophysiological center to take an electroencephalogram, for an ultrasound scan of the brain, for X-rays of the cervical spine, for consultations of narrow specialists.

One of the reasons is a violation of labor, birth trauma, lack of oxygen in the fetus. In this case, a displacement of the cervical vertebrae could occur. The displaced vertebra slightly squeezes a nearby blood vessel. This is how the blood supply to one of the parts of the brain is disrupted, and the oxygen saturation of the brain tissues is depleted. A signal of this is a headache, often in a clearly limited area: in the temples, forehead, crown. Sometimes the displaced vertebra pinches the nerve plexus, which leads to skin numbness and pain in the head. Against the background of the same lack of oxygen in the fetus, as a rule, all kinds of disturbances in the work (or formation) of the structures of the brain and the entire central nervous system develop. In this case, he will also suffer from frequent headaches.

Another reason is autonomic dysfunction (vegetative-vascular, neurocirculatory dystonia). This condition may be associated with a period of rapid growth of the child, when the internal organs and blood vessels lag behind in growth from the bone skeleton, in connection with which spasms or excessive relaxation of the muscles of the vascular wall occur. Headache is a response to insufficient blood supply to the brain from such vessels. Vegetative dysfunction is often associated with an overload of the brain due to the wrong daily routine of the student, due to increased classes at school, lack of sleep, and psychological trauma.

The third reason is the consequences of head injuries, when, due to a bruise, the outflow of fluid from the cavities of the ventricles of the brain is disturbed, an increased intracranial pressure occurs, and the inflow and outflow of blood is disturbed.

The fourth reason is that very severe headaches can be a sign of a growing brain tumor. They may be accompanied by loss of consciousness, double vision, and vomiting. This is due to the compression of the vessels and cavities of the cerebral ventricle by the tumor.

Children often have headaches if they have little time outside or lack of sleep. Therefore, so that yours does not suffer from headaches, adjust the daily routine. The child should study and sleep in a well-ventilated area. Make sure he sleeps 9-10 hours as much as possible.

Do not forget that TV and monitor screens are sources of high-frequency radiation, which primarily affects the brain, causing vasospasm and, as a result, headache, memory loss, fatigue, depression or over-excitement in the child. Do not let him watch TV for more than an hour a day and play on the computer for more than half an hour.

Teach your child how to use the book correctly. The reader's head should not "hang" over the book, the distance to the book should not be less than 30 cm. Lighting should go from the left side. Violation of reading hygiene rules can lead to "eye fatigue", which often manifests itself as a headache.

If wears glasses, check if they are correctly selected, if it’s time to change lenses, buy a wider frame. Incorrectly fitted glasses can also be one of the causes of headaches in children. And most importantly: if a child has headaches and is increasingly complaining about them, it is necessary to examine him by a neurologist and ophthalmologist.

Family Doctor Magazine

Perhaps there is no such child who has never fallen or hit his head. This is especially true for babies who learn to crawl or walk. At this age, small falls and bruises are inevitable. The task of parents is to provide the child with maximum safety and teach him to correctly coordinate his movements.

However, there are situations where, after falling and hitting the head, a child may experience alarming symptoms, indicating a head injury. In this case, it is necessary to show the child to the doctor as soon as possible. What should be done if your child has fallen and what should be paid attention to first.

How dangerous are head bumps in young children?

Many parents may recall that their children when they were young constantly falling and hitting their heads. After all, at first the baby learns to sit and cannot always maintain balance, then he learns to crawl and walk, he does not always get up dexterously and quickly. And the head, as the heaviest part of the body, takes most of the blows on itself.

Yet this provided by nature, since children have large and small fontanels on their heads, it is thanks to them that the shock is absorbed and does not always pose a danger to the health of the baby. In addition, in younger children, there is more fluid between the bones of the skull and the brain than in adults. It also plays a protective role for the baby.

Therefore, most of the shocks and falls for the child end in safely... However, parents need to know which signs and characteristics of the child's behavior may indicate and require immediate medical attention.

Inspection of the impact site and first aid

If your child falls and bumps his head, the first step is to inspect the impact site and try to qualify the severity of the damage.

A lump (hematoma) formed at the site of the impact. In this case, first of all, you should apply a cold compress - it can be any fruit or a bag from the refrigerator, or a bottle of chilled liquid. Try to hold the compress over the bruised area for at least 3-4 minutes to help prevent severe swelling.
A wound has formed at the site of the impact and blood flows from the abrasion. Dampen a cotton ball or gauze swab with hydrogen peroxide and apply it to the abrasion to prevent infection. If after ten minutes the blood still hasn't stopped - call an ambulance!
There is no visible damage at the impact site... In this case, you only have to carefully monitor the child's condition for 2-3 days and note behavior that is not typical for him. It can be excessive, drowsiness, headache complaints, excessive tearfulness, and so on.

Do not give your baby no pain medications, as this will significantly complicate the examination of the child.

Immediately after the injury, try keep the child awake, since in this case you will not be able to objectively assess his condition.

Provide your child rest, do not play outdoor games. Let the child lie quietly on its side.

Symptoms of anxiety after hitting the head: when to see a doctor

In any case, after any head injury, it is necessary to watch the child, especially carefully - several hours after the blow, and pay attention to his well-being for another two to three days.

What symptoms should you watch out for? If you notice one or more of the listed signs of traumatic brain injury, see your doctor immediately. Of course, this may turn out to be a simple coincidence, but in this case, it is better to play it safe in order not to waste time if the child needs treatment.

Drowsiness, lethargy, lethargy
Tearfulness uncharacteristic for a child
Different pupil sizes of the eyes
Episode of loss of consciousness immediately after the impact
Vomiting or the child complains about
For infants - frequent and uncharacteristic regurgitation
Dizziness, inability to maintain balance
Tinnitus complaints
Blood from the nose or ears
Lack of appetite or complete refusal to eat
Bad disturbing sleep
Child's speech or hearing impairment, complaints of poor vision
Headache
Pallor of the skin
Bruising under the eyes

Potential injuries and consequences of hitting the head in a child

Traumatic brain injuries that a child could have received during a fall are subdivided into open and closed.

TO closed injuries in turn include

compression of the brain
brain contusion
brain concussion

The most serious damage is considered squeezing- in this case, a bruise may be accompanied by rupture of blood vessels, with a bruise there are foci of destruction of the substance of the brain. Shake the brain is the mildest injury. In this case, the brain is not damaged, and at the site of the impact, we can find a hematoma or bruise.

Prevention of head injuries in children (VIDEO)

Children under one year old often fall off their beds, sofas or changing tables. Never leave them unattended at a height from the floor! Even if the child does not yet know how to roll over or crawl, he can reach the edge of the table or bed and fall head first. If the baby already knows how to roll over, crawl, then it is safest to leave him on the floor. Lay him a rug or a diaper and put him down if you need to go on business. In this case, you can be sure of its safety. Children fall off the couch most often when their mothers leave them "just for one minute." Always support your baby on the changing table with one hand. If you need to leave or even turn away for a diaper or powder, take your baby with you.