Many children during their childhood have had some type of head injury either through falling, getting hit with a bat, or bumping their head on a hard surface. When my daughter was young, and being an active child, she has had several head injuries. In fact, she still has a bump on her head from one of her injuries.
The important fact that I have become aware of recently, is that not all head injuries require a brain scan. When I brought my daughter to the Emergency Room, she was not required to have a brain scan, and fortunately she was not left with any damage to the brain.
Although brain scans are important in order to get information, and to make certain that everything is okay, it is not a good idea to expose kids to radiation unless it is absolutely necessary. Doctors seem to be very careful about this these days, not only with children, but with adults as well.
It is important to avoid brain scans (CT scans) with children, when possible, because a single CT scan exposes a child to ionizing radiation. This exposure can cause a lifetime risk of a lethal cancer. Young children are more at risk than adults because their tissues are more radiosensitive than that of an adult.
Instead of giving a child a brain scan, doctors observe the child in the ER. During this period, the doctor observes the progression of the injury or an improvement of symptoms such as headache, vomiting, or mental status in general. The medical profession does not know exactly how long to observe children with head trauma, but current guidelines suggest 4-6 hours from time of injury should be adequate.
If the injury to the head seems to be minor such as a bruise or a small bump, then a parent can apply ice to the swelling, without having to go to a doctor. It is important to observe the child, even though the injury seems mild. Observations can be; how is your child acting? Does the child remember anything that happened before or after the accident?
If there is constant vomiting, or if the child is pale, sweaty, or weak, it is important to see a doctor. Even if the bump seems small, a parent may think there is nothing to worry about. One must be aware that there could be internal bleeding.
Internal bleeding can cause pressure on the brain, which can cause the pupils of the eyes to become unequal. A slow or irregular pulse is also a sign of internal bleeding. If the accident happened during the evening, and the child went to bed, make certain that the pupils are checked and check the pulse. It is important not to wait until morning because of a probability of internal bleeding.
Source: L.A. Parent(magazine) Article: More Observation Could Mean Fewer CT Scans in Kids With Head Injuries
Taking Care of Your Child by Robert H. Pantell, M.D., James F. Fries, M.D.
Donald M. Vickery, M.D