A small child often hits his head with consequences. What to do if a child hits his head during a fall

Once a child begins to walk, falls and injuries become commonplace for parents. Often, a child hits his head while playing - this can be a collision with an obstacle while running, hitting the corner of a table, falling on the floor or asphalt. Babies also often get bumps and bruises as soon as their mother turns away for a second. As a rule, such situations frighten parents, and they call a doctor in panic. How to determine how badly a child is injured, what to do first and when to sound the alarm - we will consider below.

Inspection of the injured area and first aid to the child after an impact

If a child falls and hits his head, an initial examination should be performed immediately. A hard landing on the asphalt may be accompanied by external damage - scratches, abrasions on the forehead. In this case, they should be treated with hydrogen peroxide. If skin are not damaged, the injury is assessed in stages:

The lump indicates a bruise of the soft tissues of the head (we recommend reading:). As a rule, in children it disappears within 1-2 hours.
A hematoma may form at the site of injury - its appearance indicates damage to the blood vessels. However, a bruise can also occur due to a crack in the skull, which is much more dangerous.
Severe bleeding and a deep wound are a reason to call ambulance.

After examining the bruise, ice should be applied to the child's forehead. Its pieces should be wrapped in a clean cloth (handkerchief) and pressed against the affected area for 10-15 seconds. Then take a short break (5-10 seconds) and press again. Instead of ice, you can use a chilled spoon, frozen meat or other cold object. The procedure should be carried out within a quarter of an hour. Usually these actions are enough for the lump to disappear, and the hematoma to become smaller and resolve faster.

After hitting your head, you should briefly apply a cold compress to your forehead.

Associated symptoms after hitting your head

This article talks about typical ways to solve your issues, but each case is unique! If you want to find out from me how to solve your particular problem, ask your question. It's fast and free!

If the head hit was not too strong, accompanying symptoms may not exist at all. In case of an unsuccessful fall, the following manifestations are possible:

Redness of the skin.
Abrasion or wound.
A lump is a swelling at the site of impact measuring 3-5 cm. Larger size requires specialist intervention.
Hematoma is a bluish discoloration of the skin caused by damage to blood vessels. A bruise, unlike a bump, does not appear immediately, but within 1-2 hours after the incident.
Pain at the site of the injury, aggravated by pressure.
Sometimes, 2-3 days after hitting the forehead, the child develops blue discoloration under the eye above which he received the bump.

What signs should you sound the alarm about?

In addition to examining the site of the injury, you should evaluate general state child. If the baby bumps into open door and crying - this does not mean that the injury is severe. Children are often frightened by an unexpected blow, so you need to try to calm and distract the baby. However, the consequences of a blow can also be a concussion or a crack in the skull.

If the blow was strong, the child needs to be shown to a doctor, so that he, in turn, can assess the severity of the blow and prescribe necessary treatment

It is important not to panic, but to pay attention to the following signs:

Pupils. Their size should be the same; if one is smaller than the other, a concussion occurs.
Unusual child behavior. If the baby is too lethargic after a fall, begins to yawn, becomes sleepy, or has short-term loss of consciousness, he should definitely be shown to a doctor.
Another sign of a concussion is nausea and vomiting (more details in the article:). U small child this symptom can manifest itself as regurgitation, it will be caused by eating.
It is necessary to measure the baby's pulse - it should be within 100 beats per minute, for an infant - 120. Slowing the heartbeat is an alarming signal.
After your baby hits his forehead, his temperature may rise. This situation also requires contacting a specialist. To rule out a crack in the skull, your doctor may recommend taking an X-ray of the head. The pediatrician will also refer you for consultation to a neurosurgeon and ophthalmologist.
Some doctors do not advise putting your baby to bed right away, even if it is time for bed. This recommendation is due to the fact that it is easier to observe the child while he is awake in order to notice deviations in his behavior in time. It’s worth trying to distract him from what happened and take a closer look at how the baby behaves.

Treatment of a bump on the forehead

Sometimes a lump on a child’s forehead becomes alarmingly large and does not disappear immediately. It is believed that the frontal bones are one of the strongest, but it is still better to show the child to a specialist in order to avoid consequences.

If the doctor does not find any serious abnormalities in the baby (cracks in the skull or concussion), big shot can be treated at home. However, it is important to ensure that secondary infection does not occur - suppuration does not form. Let's look at what parents should do and how to cope with the problem on their own.

Ointments and other drugs

In order to speed up tissue regeneration processes, damage on the forehead can be lubricated with ointments and gels that have absorbable and anti-inflammatory properties. Well, if the drug gives an anesthetic effect, then the pain from the bruise it will go faster. Our table contains the most popular and effective means for external use.

Drug name	Compound	Indications	Recommendations for use
Traumeel (gel or ointment)	Homeopathic remedy, contains extracts of yarrow, aconite, mountain arnica, belladonna, etc.	Injuries of various origins(sprains, dislocations, hematomas), inflammatory processes in the joints.	Apply to affected area thin layer 1-2 times a day. Use no more than 10 days.
Balm Rescuer	Milk lipids, beeswax, oils tea tree, sea buckthorn, lavender, echinacea extract, tocopherol, turpentine.	Abrasions, wounds, diaper rash, hematomas, bruises, sprains, skin infections, inflammatory processes on the mucous membranes.	Apply the balm to cleansed skin. It is advisable to use a bandage with an insulating layer (for example, seal it with a bandage).
Gel Troxevasin	The active ingredient is troxerutin.	Swelling and injury, muscle cramps, venous insufficiency.	It is not recommended to apply to mucous membranes.
Gel BruiseOFF	Leech extract, pentoxifylline, ethoxydiglycol, etc.	Bruises and bruises on the face or body.	Apply to affected areas up to 5 times a day. Do not use on mucous membranes.

Folk remedies

Boiled bay leaves- good aid

There are also folk remedies to eliminate cones and hematomas. We have selected several recipes that can be used to treat a child:

Bay leaf. You need to take 2-3 bay leaves and boil them for 5 minutes. Then apply the cooled leaves to the bruise for a few minutes. If the leaves are warm, the effect may occur faster.
Potato starch will help get rid of a huge lump. To prepare the product you need to take 2 tbsp. l. starch and dilute it with water to the consistency of thick sour cream. Apply the resulting ointment to the bump and wash it off after a while. Use until completely absorbed.
Normal laundry soap grate on a fine grater, mix 1 tbsp. l. shavings with egg yolk. Apply the resulting mixture to the bruised area every 2-3 hours. Wash off at the end of the day.
Apply a banana peel to the injured area inside for 5-15 minutes.
Spread the formation with melted butter. Repeat the procedure every half hour.
You can apply not ordinary ice to the site of the bruise, but frozen water with the addition of chamomile, string, and sage.

Every child can fall and hit the back of their head. This happens in at different ages, whether he is a month, a year, 2 years old, and under any circumstances, but such a fall often causes a shock to any mother. Any head injury can lead to the most serious consequences, but if your child falls and hits the back of his head, the main thing is not to panic, but to provide first aid correctly. Today we’ll talk about what to do in such situations and what consequences such blows can cause.

What to expect

Small children are restless, therefore, only after learning to walk, they begin to attract various injuries. Usually these are minor abrasions, bruises, cuts, bumps, but the situation can be much more serious. For example, if a child, by an absurd accident, hits the back of his head on any surface: asphalt, floor, corner, etc.

The baby’s body is not yet so strong, which is why children face frequent fractures. Children's brain tissue is also very fragile and cannot be damaged. a lot of work. Therefore, a strong blow to this area can lead to traumatic brain injury (TBI). This type damage occurs:

open (with violation of the integrity of bones and tissues);
closed (no visible damage).

In turn, closed TBI is divided into the following types:

bruise of brain tissue;
concussion;
brain compression.

If a child hits his forehead or the back of his head, a bruise will be the mildest injury. The brain itself will not be harmed. However, if we are talking about a concussion, or even more so, compression, then everything is much worse. But how can we determine the nature of the baby’s damage? There are several characteristic features for every injury. For example, symptoms of a concussion may include:

Loss of consciousness.
Vomit.
Increased sweating.
Pale skin color.
Lack of appetite.

If a child falls and hits the back of his head, causing a bruise, you may notice interrupted breathing and irregular heartbeat. With a fracture of the skull and compression of the brain, the appearance of cerebrospinal fluid (CSF) is noted light color, and the tissue around the eyes can turn blue.

Symptoms usually take time to appear, so be extremely vigilant. It is better not to go far at all in the first few hours. If the child cries for a quarter of an hour and calms down, then most likely everything is fine and you will not need an ambulance. If you still have doubts and are afraid that you did not notice the absence of damage, it is better to contact a specialist who will examine your baby and tell you what to do next. It is better to be extra vigilant and examine the child than to deal with the consequences of a fracture.

The arriving specialist can examine the baby and refer him for neurosonography. This procedure can be performed on children up to one and a half years old whose fontanel has not yet become overgrown. The method is absolutely safe and includes examination using an ultrasound machine. Neurosonography allows you to detect an increase in intracranial pressure, which can lead to unpleasant consequences.

We found possible troubles and their symptoms, which may appear in a child after a fall or blow to the back of the head. Next, we’ll talk about how to provide first aid to your baby for certain injuries.

We provide first aid

First aid in such a situation will depend on the nature of the injuries the child received as a result of the blow. If you have a lump on the back of your head, the first thing you need to do is apply something cold (ice is best). If you have magnesium in your home, you can use it; experts (including Komarovsky) recommend making lotions with it 2 times a day.

Is the child bleeding? You should definitely have gauze swabs at home for this case. However, if the bleeding continues for more than a quarter of an hour, call a specialist. It is important not to let the baby sleep in the first hours after the impact. Try to watch him and talk. Based on his reaction, the presence of brain damage can be easily determined. At night, experts advise waking up the baby and checking the coordination of his movements. If, nevertheless, the fact of injury is recorded, any visual stress is contraindicated for the child for a week.

If the baby loses consciousness or the bleeding does not stop long time, you need to urgently call an ambulance. If the child loses consciousness, it is necessary to turn him on his side; this will prevent him from swallowing his tongue and choking when vomiting occurs. When falling from a height onto the back, spinal injuries may also occur; in such cases, the baby’s position should be changed with the utmost caution.

There are a number of symptoms for which an ambulance must be called immediately. Let's list them below:

Bad feeling.
Dizziness, severe drowsiness.
Jerking of limbs, convulsions, paralysis.
Pallor of the skin.
Vomit, feces, urine mixed with blood.
Dilation of the pupils without any reaction to external stimuli.

As you know, it is better to prevent any trouble, so pay Special attention to prevent such situations. Small children should not be left alone on the changing table, and if you need to leave, it is better to place the child on the floor (of course, not naked). Changing tables are generally very unreliable; a small area often leads to a fall of a baby who has already learned to roll over. Therefore, it is better to carry out swaddling on a soft surface.

All babies are very mobile, so various bumps and abrasions are normal occurrence. In most cases, they fall upside down. Nature has taken care of protecting the child’s brain, so in general such blows are not capable of causing 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 impacts

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 normal. How do you know if you should worry?

Forehead strike

The consequence of a child falling head down and hitting his forehead is the appearance of a bump. This occurs due to injury to small vessels and filling of surrounding tissues with blood. The result is swelling and hematoma. Due to the fact that the forehead bones are quite strong, these injuries are not dangerous. But, if a baby develops a lump after a fall, then it must be shown to a doctor who can determine the extent of the damage and rule out serious consequences.

Hit with the back of the head

Sometimes, a child may fall on his back and hit the back of his head. In this case, parents should hurry to see a doctor. This is due to the fact that such injuries cause serious problems in future. Due to the fact that in the back of the head there are nerve endings that affect the functioning of the organs of vision, it can be disrupted. The child may lose consciousness, experience trembling in the legs and general weakness of the body. And all this can happen even with a small bump.

If you see that your child has hit the back of his head, rush with him to the doctor, even if he does not make any complaints. There are times when signs of such injuries may take a long period of time to appear.

First aid

Falls and impacts are common for children, especially one-year-olds, so you should always know what to do if your child hits his head hard. Correct and timely actions will help prevent the development severe consequences injuries. Firstly, the damaged area must be thoroughly inspected. Adults should try to determine the severity of the blow, regardless of where it fell (forehead, back of the head or temple):

The appearance of a hematoma in the place where the blow occurred. Cold (ice) should be applied to the site of swelling as quickly as possible. A bottle filled with cold water or a handkerchief moistened with water will also work. It is necessary to hold such a compress for about 5 minutes to alleviate the condition and reduce 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 prevent various pathogens from entering through the wound. If you cannot stop the bleeding immediately, call an ambulance.
The baby could have hit himself, but there is no damage in this place. Parents should carefully monitor him for a few more days, noting any deviations from the norm in his behavior or condition. or dizziness, become moody and irritable, sleep for a long time or get tired easily. All this may indicate a concussion or some other serious injury. If you notice a sharp deterioration in his condition, loss of consciousness, nausea and vomiting, you must urgently call a doctor.

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

At the same time, the main thing is to do everything to keep him awake for several hours, because many of them immediately begin to feel sleepy. This is done so as not to miss serious symptoms and determine the severity of the injury.

Doctors recommend waking up your baby at night to test his coordination. After a few days, if he continues to feel well and nothing bothers him, then the parents can calm down. In the first time after the injury, he should spend more time walking outside, but avoid active pastime.

Alarming symptoms

Every baby can fall down to the floor or hit his head on furniture or any other objects. If this happens, parents should monitor him. Moreover, any exercise stress should be kept to a minimum. Older children need to limit their brain activity - prohibit them from 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 hit their foreheads. A visit to the doctor should not be postponed if parents notice:

A depression has formed in the place where the bump was.
The baby complains of nausea and vomiting.
Cannot calm down for a long time.
The lips turned blue and the skin became pale.

Tatyana Gurevich, head of the movement disorders clinic at the Tel Aviv Medical Center, talks in detail about head injuries:

The pupils have greatly increased in size or squint has appeared.
A too large lump appeared at the site of the impact.
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 should immediately show the child to a doctor. Even in cases where adults think that the injury is insignificant, consultation with a pediatrician is mandatory!

Until the doctor arrives, the victim should not be given medicines, so that the doctor can assess the real picture of the damage. The baby should lie on its side while awaiting examination.

After being hit with the back of the head

If the blow falls to the back of the head, the symptoms that should alert you will be almost identical. Additionally, numbness of the extremities, loss of consciousness (can be prolonged), blurred vision (cloudedness, complete absence etc.), tinnitus, severe dizziness, poor coordination and memory loss.

Such impacts are often the cause. And even if the baby just fell on the floor, hitting the back of his head, this condition cannot be ignored. So that there is no negative consequences, it is better to show the child to a doctor immediately.

Older children and teenagers can be injured by falling backward while roller skating, biking, or fighting. To avoid trouble, it is important to teach your child how to fall correctly as early as possible, and when riding a bicycle, you must use a protective helmet.

Possible consequences

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

It is possible that your health will begin to deteriorate after some time. Children may complain about headache, memory problems. They become moody, sleep and appetite are disturbed.

When hitting with the forehead

Children are most likely to fall forward and hit their forehead. In such situations, the simplest manifestation of injury will be a lump. There are 2 types of traumatic brain injuries:

Closed - without violating the integrity of the bones of the skull and skin. There are mild injuries (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 impaired and bleeding occurs.

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

Closed injuries include the following:

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

. In this case, after the blow, the children lose consciousness. The skin around the eyes darkens, and the ears and nose may bleed. In this case, you need to call an ambulance. Other signs of brain contusion include: impaired speech and facial expressions, damage to the facial nerve.
Soft tissue bruise. 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 hitting your head

When hit 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 a doctor to avoid serious consequences:

Impaired perception. When the blow comes 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 diagnosed extremely rarely.
Children may become inattentive. Sleep is disturbed, memory deteriorates. The baby is being tortured.

Dr. Komarovsky talks about childhood head injuries and in which cases it is necessary to urgently consult a doctor:

Such consequences can be avoided if you show the child to a doctor as soon as possible after the injury occurs.

Injury Prevention

Any fall can result in a head impact. To avoid this, adults should not leave young children unattended, no matter where they are (on the sofa, changing table, crib or stroller). They may roll over or try to crawl, causing them to fall and hit themselves. If you need to leave the room where your baby is, place him in a playpen or lay him on the floor where he will be safe.

While changing your baby's clothes, hold him with your free hand. When your child is sitting on the bed, even if you are nearby, place several pillows on the floor. Children are incredibly active and it is not always possible to keep track of them.

You cannot neglect safety precautions when walking in a stroller. When choosing a stroller, pay attention to models with high sides. And when placing your child there, be sure to fasten him with seat belts.

Children who are learning to walk are especially likely to fall. At this time, their legs are not yet strong enough and it is easy for him to trip or slip. To make your baby comfortable, wear socks with special rubber inserts on the feet that will prevent him from slipping on the floor. It is equally important to protect surrounding objects and furniture. Sold specifically for sharp corners silicone pads. Parents can also cover such areas with a soft cloth.

When going down the stairs, you need to hold the child's hand tightly, as the baby can easily slip and fall down. And this is extremely dangerous. One of the most dangerous places for children is the playground. To prevent injury to children, parents should always be with them. This is especially true when riding on swings or playing on high structures.

For older kids who are starting to rollerblade or bike, always wear a protective helmet, which can always protect the child's head from injury when falling. It is important for children who play sports to learn how to fall correctly and group themselves while doing so.

The head is not only the most important, but also the most vulnerable part human body. That's why she needs careful attitude. The main task of adults is to monitor the baby and talk with an older child, during which he needs to explain the importance of safety precautions in everyday life. If it does happen that the child falls and hits his head, he must be shown to a doctor to rule out serious injuries.

The appearance of a child in a family requires constant attention and care from adults for the baby. And although, as a rule, all family members are well aware of this and are completely absorbed in the child, there are nevertheless frequent cases when children of the first year of life, left unattended even for a short time, fall from a height (from a changing table, from a crib, stroller, from the hands of parents, etc.) and receive a head injury (traumatic brain injury).

Typical cases of traumatic brain injury in infants

The baby lies on the changing table or on the sofa, the mother turns away for a few moments, and the baby falls to the floor.
The baby is left unattended in a high chair. He pushes off the table with his feet and falls on his back along with the chair.
The baby is trying to get up in the crib. Something on the floor interested him, and he hangs over the side and falls.
The little one was left sitting in the stroller, not expecting that he would try to stand up in it and, not finding support, would fall down.

What is traumatic brain injury

Traumatic brain injury (TBI) is mechanical damage to the skull and intracranial structures (brain, blood vessels, nerves, meninges). The manifestation of traumatic brain injury in children differs significantly from the symptoms characteristic of adults, and they are determined by the characteristics of child's body, namely:

the process of ossification of the baby’s skull is not yet complete, the bones of the skull are plastic, flexible, their connection with each other is loose;
the brain tissue is immature, saturated with water, differentiation of the structures of the nerve centers and the cerebral circulatory system is not complete.

Thus, on the one hand, brain tissue has greater compensatory capabilities and a so-called safety margin (soft bones of the skull and a larger amount of fluid in the brain than in adults can absorb shock). On the other hand, since it is the immature brain tissue that is exposed to trauma, this can lead to disruption of the development of its structures and provoke further limitations. mental development, emotional disturbances, etc.

Classification of traumatic brain injuries

There are several types of traumatic brain injuries:

Open head injuries are head injuries in which the integrity of soft tissues and skull bones is damaged. If the dura mater is also damaged, the injury is called penetrating. In other words, the traumatic agent penetrates not only into the cranial cavity, but also reaches the brain. There is a threat of infection, which dramatically complicates the healing process of the injury.
Closed head injuries are injuries to the head in which the integrity of the soft tissues (or there are only minor abrasions or scratches) and the bones of the skull is not compromised. Most often, when falling from a height, children in their first year of life receive closed TBIs. In turn, closed injuries are divided into:

concussion (without division into severity);
mild, moderate and severe brain contusion;
brain compression.

Concussion (commotio)- mild form of traumatic brain injury. Damage to the brain occurs at the molecular level (molecules are shaken), while its functions are disrupted, but there are no obvious changes in the structure of the brain substance.

Brain contusion (contusio)- brain damage, characterized by the appearance of a focus/foci of destruction of the brain matter varying degrees gravity. The lesions can be single, multiple, different in depth and location. In this case, the patient develops neurological disorders (for example, the inability to make a certain movement with the hand, etc.) and/or psychological changes.

Compression of the brain (commpressio)- severe damage to the brain substance, which, as a rule, occurs against the background of a brain contusion and extremely rarely without it. The causes of compression of the brain are the accumulation of blood inside the skull as a result of a ruptured vessel, or the brain can be compressed by fragments of the skull in a so-called depressed fracture.

External manifestations of head injuries

Because the relative weight If the baby's head is significantly larger than the weight of the body, then when he falls, he first of all hits his head and most often the parietal region. Very rarely the frontal and occipital areas of the head are injured. After a child falls, redness appears in the impact area, and the baby feels pain. If, within a few minutes, no pronounced rapidly growing swelling appears in this place, but only slight swelling is noted, then, as a rule, this indicates a contusion of the soft tissues of the head (which is not a TBI). You need to apply something cold to the sore spot (an ice pack, a towel moistened with cold water - do not forget to re-wet it periodically, etc.). A cold compress is applied for at least 5-15 minutes (or at least for as long as the baby allows - often this procedure causes active protest). And most importantly, remain calm and try to calm the child. External signs of a concussion in children of the first year of life are quite scarce. For infants, loss of consciousness due to a concussion is very rare, in contrast to preschool and school age and adults. They also cannot complain of a headache. They just immediately begin to cry loudly, and motor restlessness arises. After screaming they can fall asleep. When they wake up, they become capricious and refuse food. Then vomiting appears (usually once) or frequent regurgitation. Children do not sleep well the first night after injury. The more pronounced these disturbances in the child’s behavior are and the longer they last, the more likely it is that the brain will suffer. Another reaction to trauma is also possible: after a child’s sleep external signs injuries disappear and a false impression 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 a sign often indicates a brain injury. But sometimes in such a situation, parents lose track of time, it is difficult for them to navigate whether a lot of time has passed since the child fell or not, whether there was a loss of consciousness or not. Even if the child simply started screaming from the blow, but before that it was quiet for some time, parents should be wary of this situation and should be attributed to a more severe pathology. This will allow you to apply for medical care and determine the severity of the injury. A brain contusion is accompanied by a violation of its blood flow of varying degrees of severity (from reduction to complete cessation), swelling of the brain substance, hemorrhages in the brain, and the development of paresis and paralysis is possible. Other signs of pathology are the same as with a concussion, but only more pronounced: repeated vomiting, prolonged anxiety, etc. With severe brain contusions, coma develops. If, as a result of a brain injury, a hemorrhage occurs in its substance, then this leads to compression of the brain, which may damage the vital centers of breathing and cardiac activity, which disrupts their functioning until the complete cessation of the body’s vital functions. As a rule, children with intracranial hemorrhages experience depression of consciousness. The degree of impairment of consciousness may vary depending on the degree of brain damage - from severe drowsiness to a coma. When falling from a height, children may experience fractures of the skull bones (open TBI), which can also compress the brain. Fractures of the skull bones in infants are most often determined by cracks and linear fractures. Based on their location, length, and width, one can judge the severity of the injury. Thus, divergence of the edges of a bone fracture may indicate that there is a rupture of the dura mater, and this is an indication for surgery. Depressed fractures (dents) are more rare. In this case, the bone is concave inside the skull, bone fragments compress the brain. Such fractures also require surgical intervention. Rapidly growing swelling appears in the fracture area, which may be the result of blood accumulation in soft tissues(hematoma) due to damage from bone fragments. Often, it is the presence of such swelling (bump) on the child’s head that forces parents to consult a doctor, while the moment of injury or its consequences go unnoticed.

What to do first if a child falls

We strongly advise parents whose children have suffered a head injury: even if, in your opinion, nothing is bothering the baby, he fell from a small height, stopped crying, etc., immediately seek help from to the next doctors: pediatric neurologist, traumatologist, neurosurgeon. To do this, you need to call an ambulance at home, and you and your child will be taken to a specialized hospital, or contact the specified specialists yourself. If they do not confirm the pathology, you can safely return home. Failure to consult a doctor is dangerous due to late diagnosis of the injury, aggravation of its healing, and the possibility of coma. All this requires treatment in intensive care, and in some cases, surgical intervention. Delayed access to a doctor increases the risk of death, lengthens the recovery period and worsens its outcome, to the point that the child may become disabled.

Where are traumatic brain injuries treated?

By existing rules(standards), all children with traumatic brain injury should be hospitalized. Children with a concussion (mild traumatic brain injury) can be treated in the neurological and neurosurgical departments. Patients with more severe forms of injury should be treated in a neurosurgical department (if there is one in a particular region). To carry out justified, targeted treatment requires a comprehensive examination of the child, which is only possible in a hospital. This examination includes thorough research nervous system, vestibular apparatus, organs of vision, hearing and other studies. In the emergency department, the child is examined, signs indicating damage to the skull bones or brain injury are identified, parents are asked about the child’s condition after the fall, etc.

Methods for diagnosing traumatic brain injuries

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

If intracranial hemorrhage is suspected (especially if 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 used to puncture the area of the second - fourth lumbar vertebrae of one of the spaces of the spinal cord (subarachnoid space) and collect a portion of cerebrospinal fluid for examination under a microscope. The presence of intracranial hemorrhage is determined by the presence of blood cells in the cerebrospinal fluid. In addition, there are more complex methods studies of the child’s head: computed tomography (CT) and magnetic resonance imaging (MRI).

Computed tomography (CT) (from the Greek tomos - segment, layer + Greek Grapho - write, depict) is a research method in which images of a certain layer (slice) of the human body (for example, the head) are obtained using X-rays. In CT scans, the rays hit special device, transmitting 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. In this way, the smallest changes in the absorption of rays are recorded, which in turn allows you to see what is not visible on a regular x-ray. It should be noted that radiation exposure with CT is significantly lower than with conventional X-ray examination.

Magnetic resonance imaging (MRI) is a diagnostic method (not associated with x-rays) that allows you to obtain layer-by-layer images of organs in various planes and 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 cessation of exposure to the radio frequency pulse. For MRI, various pulse sequences have been developed to image the structures under study 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 in the early childhood difficult, due to the need to conduct this examination in children in a state of immobility (under anesthesia), since necessary condition successful implementation technique is the immobility of the patient, which cannot be achieved from an infant.

Treatment tactics for traumatic brain injuries

After the examination and clarification of the diagnosis, treatment tactics are determined. Children with mild traumatic brain injury are prescribed drug treatment(therapy aimed at eliminating cerebral edema, lowering intracranial pressure, correcting metabolism in the brain, etc.). Surgical treatment It is used (and necessary) primarily to eliminate compression of the brain. It is prescribed to children with depressed fractures of the skull bones and intracranial hemorrhages. Parents need to realize that only a comprehensive, adequate examination of the child allows him to correctly and timely treat his brain injury, achieve recovery and avoid his disability.

Consequences of traumatic brain injuries

Research on traumatic brain injury suggests that even mild trauma can cause 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 the organs and systems subordinate to them (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 may narrow inadequately, leading to increased blood pressure. All this worsens the course metabolic processes in the brain, as a result of which brain cells can be replaced by cystic cavities, that is, holes filled with fluid form in their place, and in the place where these cysts are, certain brain functions are lost. For example, the frontal lobes are responsible for intelligence - This means that the presence of cysts in this place reduces it. In addition, it is known that the brain normally has cavities inside and outside filled with cerebral (cerebrospinal) fluid. After injury, it can accumulate excessively in the cranial cavity - and consequently, intracranial pressure increases. The fluid under pressure compresses the substance of the brain, causing its slow atrophy (these phenomena are also characteristic of the formation of cysts). Running these pathological mechanisms depends on the severity of the injury: the more severe it is, the more pronounced the impairment, the worse the outcome, the longer recovery period. For mild traumatic brain injury (TBI), the prognosis is usually favorable - provided that the recommended regimen and treatment are followed. After recovery, phenomena of asthenia are possible - the child quickly gets tired, becomes inattentive, and irritable. At the same time, the baby is more inhibited, which can lead to repeated injuries. These phenomena may further affect intellectual development child. For TBI medium degree severity, it is often possible to achieve complete restoration of activity, although a number of children develop asthenia, increased intracranial pressure, frequent headaches, and impaired coordination. With severe TBI, the prognosis can be unfavorable - mortality in these cases reaches 15-30%. After recovery, a wide variety of consequences are possible: from varying degrees of motor impairment, severe convulsive attacks to severe mental disorders and consciousness, which leads to disability. With an open head injury, purulent-inflammatory complications often occur (for example, meningitis - inflammation of the membranes of the brain, etc.), which can also lead to death. 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. Nevertheless, studies have shown that 1-3 months after a concussion, at least half of the children show certain 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.

How to Reduce Your Chance of Traumatic Brain Injury

Injuries in children most often occur in the presence of adults, and this once again indicates our inattention or frivolity and carelessness, as well as the fact that we have a poor understanding of the motor skills of the baby. Parents should anticipate the development of new motor skills in the child and take safety measures. So, one month old baby, lying on his stomach, he can push off with his feet from the side of the changing table, from the back of the sofa, bed and fall. Each subsequent skill or movement of the baby (attempts to sit, crawl, stand, etc.) can also lead to “unexpected” injuries. A child, trying to get up, may fall out of the stroller or high chair, especially if they forgot to fasten it. Parents, unaware of the baby’s new capabilities, are overly careless, leaving him unattended. If you need to leave, do not leave the child alone lying on any high (or not very high) surface, put the baby in a crib, playpen or even on the floor. Fasten your child in a high chair and stroller. If there are stairs in the house, install a safety fence so that your child cannot fall down or climb high and then fall. “Walkers” can also be unsafe: children, while in them, can be pushed off strongly, hit something, roll over, and also fall down the stairs. It is better to avoid using such a vehicle. “Jumpers” are dangerous due to the unpredictability of their movements: for example, a child wearing them can collide with a wall. The most important role In reducing childhood injuries, prevention is given priority, and the main thing in it is the attentive attitude of adults towards children and their safety. Among the various injuries to the body, head injuries account for 30-50% of all injuries in children. And every year this figure increases by 2%.

There is not a single baby who has never fallen. They fall when they learn to crawl, walk, when they play. And every time a child falls to the floor and hits the back of his head hard, parents involuntarily wonder if everything is okay with their baby, if he has any injuries after the bruise. What should you do if your child hits his head or the back of his head? After all, the back of the head is the most vulnerable place in children.

Let's imagine such a situation. The child was playing calmly on the bed. Mom looked after him closely. But as soon as she left for a minute, for example, to get water, the little one fell to the floor, hitting the back of her head hard. The parents are in a panic, they don’t know what to do or how to do it, the baby is crying a lot. What should the mother do in this case, how can she find out that the baby, after he fell on the floor, does not have a severe bruise or even a concussion?
Let's try to figure it out step by step, what to do if the baby hits the back of the head or any other part of the head?

Step 1: Assess the situation

Parents need to calm down, not panic and soberly assess the situation. From what height did the baby fall, on what surface? If, for example, the baby fell from the bed onto the floor, onto a soft carpet, then most likely everything is fine with him, and the baby will only get away with fear and a small bruise. If he fell from his high chair, or from a stroller, or fell on a hard tiled floor or on floor tiles, then he stands here
be on your guard.

Step 2: Baby Care

It is necessary to assess the child’s well-being. If he falls to the floor, he may lose consciousness, although not for long. Therefore, if after the baby fell, he did not cry for the first two or three minutes, this may mean that the baby lost consciousness. The child, after being hit with the back of the head, needs to be calmed down and placed on the bed. You need to carefully monitor your child and not let him sleep. If you notice any of the symptoms described above in your child, you should definitely call an ambulance or take him to the doctor yourself.

Step 3: Treating the Damage Site

Inspect the site of the injury. If there is a bruise in its place (it does not appear immediately, but after two or three hours), then you must apply a cold compress to avoid the appearance severe swelling. If there is an abrasion or wound at the site of the injury, it must be disinfected with a peroxide solution, treated with brilliant green and covered with a band-aid. Healing ointments can be used later. Such as Baneocin, Bodyaga, Astroderm, Boro-plus and others. If blood flows without stopping for more than 15 minutes, then this is a good reason to consult a doctor.