There are many causes of head injury in children. Common causes are:

• Sports injury
• Falling
• A motor vehicle accident, or being struck by a vehicle while walking
• Child abuse

The risk of head injury is high in teens. Head injuries happen twice as often in boys than in girls. Head injuries are more common in the spring and summer months, when children are very active in outdoor activities such as riding bikes, roller skating, or skateboarding. Children who play sports such as football, soccer, hockey, and basketball are also at higher risk of concussion.

Symptoms can occur a bit differently in each child and vary depending on how severe the injury is.

Symptoms of mild head injury may include:

• Raised, swollen area from a bump or a bruise
• Small, shallow cut in the scalp
• Headache
• Sensitivity to noise and light
• Irritability or abnormal behavior
• Confusion
• Lightheadedness or dizziness
• Problems with balance
• Nausea
• Problems with memory or concentration
• Change in sleep patterns
• Blurred or double vision
• Eyes that look tired
• Ringing in the ears (tinnitus)
• Changes in taste

Symptoms of moderate to severe head injury may include any of the above plus:

• Tiredness or trouble staying awake
• Loss of consciousness
• Severe headache that does not go away
• Repeated nausea and vomiting
• Loss of short-term memory
• Slurred speech
• Trouble walking
• Weakness in one side or area of the body
• Sweating
• Pale color of skin
• Seizures or convulsions
• Blood or clear fluid draining from ears or nose
• Pupil looks larger in one eye
• Deep cut in the scalp
• Loss of consciousness and can’t be awakened (coma)
• Loss of thinking and awareness of surroundings (vegetative state)
• Locked-in syndrome, a condition where a person is conscious and can think but can’t speak or move

The symptoms of head injury can be like other health conditions. Make sure your child sees their healthcare provider for a diagnosis.

The healthcare provider will ask about your child’s symptoms, health history, and recent injuries. They will give your child a physical exam. Your child may also have tests, such as:

• Blood tests. Samples of your child’s blood may be taken to check for problems.
• X-ray. This test uses electromagnetic energy beams to make images of internal tissues, bones, and organs onto film.
• MRI. This imaging test uses large magnets and a computer to make detailed images of organs and tissues in the body.
• CT scan. This test uses X-rays and a computer to make detailed images of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than standard X-rays.
• Neuropsychological testing. This is to find out if there is a problem with brain function after a head injury.

Children playing organized sports will usually have an "ImPACT" test. This measures a child's brain processing. Children will usually have this test at the beginning of the sports season and then again should they have any head injury.

Head injury can cause nervous system problems and may need further medical follow-up.

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.

A child who has a concussion should not play sports or do other activities until a healthcare provider determines that it's safe to do so. Ask your child's healthcare provider for this information in writing and give a copy to your child's coach. In an age-appropriate manner, explain to your child why this limit on sports and activities is important. A child who gets a second concussion before symptoms of the first concussion have gone away can end up very severe brain injury. Athletes with concussion are gradually and slowly allowed to do more exercise.

Treatment may include:

• Rest
• Ice on the area
• Antibiotic ointment and a bandage
• Stitches in the scalp to close a wound
• Being watched for a period of time for problems

In some cases, a child may need to stay in the hospital. They may be watched more closely for problems. A child may also need:

• Medicine to cause them to relax or sleep (sedation)
• Help with breathing from a breathing machine (mechanical ventilator or respirator)
• Diagnostic tests
• Surgery
• Referral to a traumatic brain injury specialist

A child may also need monitoring for increased pressure inside the skull. This is called intracranial pressure (ICP) monitoring. A head injury may cause the brain to swell. There is only a small amount of room for the brain to swell inside the skull. This causes pressure inside the skull to increase and can lead to brain damage.

ICP can be measured in 2 ways:

• Place a small hollow tube (catheter) into the fluid-filled space in the brain (ventricle).
• Place a small hollow device (bolt) through the skull into the space just between the skull and the brain.

In both cases, the ICP device is inserted by the healthcare provider either in the intensive care unit (ICU) or in the operating room. The ICP device is then attached to a monitor that gives a constant reading of the pressure inside the skull. If the pressure goes up, it can be treated right away. While the ICP device is in place, your child will be given medicine to stay comfortable. When the swelling has gone down and there is little chance of more swelling, the ICP device will be removed.

Talk with your child’s healthcare providers about the risks, benefits, and possible side effects of all treatments.

Children who suffer a severe brain injury may lose some function in muscle, speech, vision, hearing, or taste. This depends on the area where the brain is damaged. Long- or short-term changes in personality or behavior may also occur. These children need lifelong medical and rehabilitative treatment. This may include physical, occupational, or speech therapy.

How well a child recovers from a head injury depends on the type of injury and other health problems that may be present. It is important to focus on maximizing your child's abilities at home, school, and in the community. You can encourage your child to strengthen their self-esteem and have independence.

If the child has a long recovery or possible long-term (permanent) disabilities, community resources and legal protections may be helpful. The Americans with Disabilities Act gives children with disabilities special help in the public school system. Check with your school's principal for information.

Head injury can be prevented in ways such as:

• Work to ensure safe playing environments for children.
• Create a safe sports culture. Make sure that coaches teach and enforce correct sporting techniques such as no head hitting in football. They should also know first aid and have a concussion action plan in place.
• Check that children wear a seat belt when riding in any vehicle. For younger children, have them ride in the correct car seat or booster seat for their age and weight.
• Make sure children always wear the correct helmet while playing sports, riding bikes, roller skating, skateboarding, or skiing.