It is routine procedure for all children under the age of two years, who have suffered a head injury to be seen at GOSH by a social worker, consultant neurologist and ophthalmologist as well as having routine bloods and x-rays of the whole skeleton. If we have identified the source of the infection (using a series of blood tests, swabs, urine tests and/or x-rays) we will give your child antibiotics, either by mouth or directly into the bloodstream. Infection may be at risk if the skin or the skull has been broken, both at the time of the injury and afterwards. This medication will eventually be reduced and sometimes stopped completely but this may not happen for some time after the head injury. Your child will be given medication to help prevent seizures. If your child suffers a seizure or a convulsion, it does not mean that they have epilepsy or will continue to have seizures for the rest of their life. They are generally caused by irritation to the brain from swelling or bleeding. Seizures (fits/convulsions) may happen immediately after the injury or several days later. The way we monitor intra cranial pressure is explained in greater detail later. This swelling causes a rise in pressure within the brain (intra cranial pressure or ICP). It can occur within hours or it may not happen for a few days. Swelling of the brain affects most children after a severe head injury. ![]() On most occasions, no surgical treatment will be needed as the body reabsorbs the blood over time, but occasionally an operation may be necessary. Intra-cerebral haemorrhage is bleeding within the brain usually following a contusion or laceration. This is classed as a neurosurgical emergency and urgent surgery is often necessary to drain the blood from the extra-dural cavity. It is usually the result of a tear to an artery in the temporal bone (the bone at the side of the head). Surgery may be required to drain the blood or they are left for the body to reabsorb which can take up to three months.Įxtra-dural haemorrhage is where blood collects in the space between the skull and the dura. They can develop several weeks or months later following a head injury and therefore symptoms may not be noticed straightaway. This sometimes makes it necessary to drain the area several times or a shunt (a drainage tube) can be inserted into the area containing the bleed to drain the blood into another part of the body.Ĭhronic sub-dural haemorrhage forms more slowly than acute sub-dural haemorrhages and do not always require surgery. There may be persistent bleeding in the sub-dural space. In babies, a small needle can be inserted through the fontanelle or ‘soft spot’ to draw off the blood. An acute sub-dural haemorrhage will often require surgery as an emergency to remove the blood. They can be caused by the blood vessels in the brain rupturing, bleeding from bruises on the brain or cuts to the brain.īlood collects in the sub-dural space, which is beneath the dura and directly on to the surface of the brain. Haemorrhage (bleeding) following head injuryĪcute sub-dural haemorrhage can happen at the time of the injury or several hours later. ![]() ![]() These injuries often lead to swelling of the brain, contusions (bruises) or blood clots. Shearing injuries tear the nerve fibres and blood vessels. Contusions can cause parts of the brain to swell, which may make your child irritable, sleepy or sick. Bleeding can occur in and around the tear.Ĭerebral contusions are bruises to the brain, caused when the brain bounces off the inside of the skull. As the inside surface of the skull is rough, the following injuries can occur:Ĭerebral lacerations are tears to the surface of the brain, which sometimes happen after the skull is fractured. The force to the head during injury can make the brain move within the skull. If the scalp is injured and there is an underlying skull fracture that exposes the brain, an operation will usually be needed to clean the wound and repair the damaged skin and bone. However, a depressed skull fracture, where part of the skull bone has been pushed inwards, may require surgery to lift the bone and prevent it pressing against the brain. These may be uncomplicated, in which case they can heal without surgical treatment.
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