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Oak Corner

What are the symptoms I should watch for after a head injury in an infant?

My nine month old son fell down to stairs about a half hour ago and hit his head on a solid oak corner and then on a wicker basket. He has two large bumps that he doesn't want me to touch. (He promptly whines, jerks his head away and/or pushes away my hand.) Where he hit the corner, there is what looks to be a wound but there was no blood and no fluid. Just scratched the surface. He isn't unconsolable and his pupils seem fine but he is very tired, although it is past his bedtime. Should I let him go to sleep or keep him awake? And what symptoms should I keep an eye out for? Should I have called 911?

What's a concussion?
When a closed-head injury — meaning one in which no object penetrates the skull — causes a change in the normal functioning of the brain, it's called a concussion. The injury might be from a violent blow, a fall, or a severe shaking.

A child with a concussion may lose consciousness or have problems with his vision, memory, or balance. This sounds scary, but in most cases the effects are minor and temporary and the child recovers completely.

My baby fell and hit his head. How can I tell if he has a concussion?
Your baby may have one or more of these early symptoms:
• loss of consciousness

• drowsiness

• dizziness

• confusion

• vomiting

• irritability

• drainage, clear or bloody, from his nose, mouth, or ears

When should I call 911?
If your baby hits his head and starts breathing irregularly, has convulsions, or is unconscious more than a few minutes, call for immediate help. Don't move him unless he's in danger of being hurt further. Perform CPR if he isn't breathing, and if he's bleeding, cover the wound with a clean cloth and apply pressure.

When should I call the doctor?
It's common for babies to hit their heads when they fall, and in most cases there's nothing to worry about. If your baby loses consciousness, though, have him checked out by his doctor or by the doctor at the emergency room. Sometimes, even with a minor blow, the brain can be injured.

Also take your baby to a doctor right away if he hits his head and in the next day or two he:
• Is vomiting. It's okay to have a bout of vomiting after a fall, but it shouldn't persist.

• Seems unusually sleepy during the day or can't be awakened at night. Try waking your baby a couple of times the first night after his fall, just to make sure you can.

• Seems weak or confused, or seems to have problems with coordination, vision, or verbal communication.

Can a concussion cause permanent brain damage?
Only in rare cases. But a second concussion before symptoms from the first one have cleared can be dangerous, possibly causing brain damage and even death. So if your baby has suffered a concussion that caused him to lose consciousness, your doctor will probably advise you to keep an extra-watchful eye on him for the next few weeks.

How can I prevent my baby from getting a concussion?
The best thing you can do is to childproof your home. Also make sure your child is always safely buckled into his safety seat in the car.

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