Probably, there is no such child who would not fall in childhood. The problem is especially acute in infants who have only recently learned to take their first steps. Of course, nature took care to minimize the consequences of falls (the joints in the skull of an infant are quite elastic), but sometimes you still cannot do without the help of a doctor. So…

A one-year-old or one and a half year old child fell and hit his head, what to do

First of all, you need to carefully examine the site of the injury. If in the next few minutes there will be no swelling on it, and everything will be limited to only a slight swelling, in the common people - a lump, while the baby feels good, there is no serious cause for concern. A cold compress for 5-10 minutes will help in this case.

But if, after falling and hitting his head, he becomes restless or, conversely, lethargic and soon falls asleep, there is cause for concern. Watch the baby for a while and be ready to take him to the hospital immediately. This should be done when the following symptoms appear:

- the baby fainted, even if only for a few seconds;

- unnatural movements of the hands and eyes appeared;

- refusal to eat, nausea and even vomiting;

- Bleeding from the nose or ear.

All this may indicate a concussion. Therefore, when they appear, immediately take the child to the hospital or call an ambulance. If you are going to get there on your own, make sure that he moves as little as possible.

What to do if a child hits his head

Unfortunately, there is often a situation when the baby falls, for example, from the changing table or from the stroller. If this happened, and the child hit his head, it is better to play it safe and go to the hospital.

The fact is that a concussion in children under one year old outwardly manifests itself very weakly and it is not always easy to diagnose it. Loss of consciousness in the presence of a concussion in children of the first year of life happens much less often, it can be caused by anything. And the baby still cannot complain of a headache. Therefore, even if it seems to you that everything is in order, show the child to a specialist.

The doctor examined the child and said that everything is in order? Fine, you can relax a little. But throughout the week, continue to carefully observe the little one. It happens that the consequences of hitting the head appear only after some time. If something alerts you (sleep disturbances, twitching of arms or legs, poor appetite and frequent regurgitation, wide pupils, strabismus), see your doctor again.

The brain, the holy of holies of the body, seems to be firmly protected by the bones of the skull. But it is the cranium that most often causes brain damage during trauma. As you know, between the bones of the skull and the brain there are meninges and a special liquid - cerebrospinal fluid, which additionally protects the brain. During a head impact, the brain continues to move by inertia, that is, it moves inside the cranium, sharply bumping into the bones of the skull. Liquor extinguishes this movement, but not always. And with a severe injury, if there is a fracture of the bones of the skull, fragments of bones can damage the brain.

The children's skull is an even more fragile and vulnerable structure. Children are much more likely to suffer brain injury from head impact than adults. Especially in the first year of life, when the bones of the skull have not yet fused and are easily displaced upon impact.

Adults are required to know where the baby is in danger. Falling to the floor from the changing table or falling out of the stroller is a "hobby" for babies. Older children master the world, testing it for strength with their own forehead. A young traveler does not even need sharp corners - he will literally fill a bump out of the blue. And it's good if a bump. And when the baby grows up and starts running, it is not known who grabs his head more often - a frightened mother to death or he himself.

Unfortunately, it is impossible to completely protect a child from injury. If your child falls rarely - are you trembling over him too much? In the words of the excellent pediatrician Benjamin Spock, "It will preserve his bones, but ruin his character."

How can you and I, if not protect the baby, then at least reduce the risk of head injury?

Babies up to a year

Babies most often roll onto the floor from changing tables, so you need to swaddle your baby not on the table, but, for example, on the sofa. He is lower. Also, to cushion a possible fall, place a rug under the table or next to the sofa. Three more tips:
do not take your eyes off the baby for a second while swaddling;
try to hold it with your hand;
if you need to leave (for a bottle, or pick up the phone, or open the door), take the baby with you. Otherwise, he can at any moment roll over from his back to his stomach (it is better not to think about the consequences of such an acrobatic etude).

You have to watch the baby even when he lies quietly in his crib. However, lies - it's half the battle. As soon as he starts to sit down, keep your eyes peeled. If your fidget has already mastered the art of sitting, urgently get a low, stroller. And necessarily mobile, that is, one in which the child can sit and lie down. It is more difficult for him to get out of such a stroller, and it is safer to fall.

The kid has grown up

Special socks with “brakes” (these are rubberized inserts in the sole of the sock that reduce slipping) can protect the child from falling in the apartment. They are especially useful in an apartment with a parquet floor. Lay rugs in the places of the baby’s usual routes (but so that they lie tightly and do not slip on the floor). For the first time, wrap sharp corners of furniture, door jambs with some kind of dense matter. Remove chairs and other furniture from windows - this will keep an inquisitive little man from wanting to climb onto the windowsill or, scary to think, open the window.

But if still...

If misfortune happened and the child fell, hitting his head, the main thing is not to panic, not to find out who is to blame. All attention to the baby. Your task is to quickly find out how serious the injury is. How to do it?

The easiest injury is a contusion of the soft tissues of the head (not to be confused with a contusion of the brain!). In this case, the brain does not suffer in any way. There may be a small abrasion or bump at the site of impact. The child, having sobbed for 10-20 minutes, calms down and behaves as usual. In this case, you can not consult a doctor.

With a concussion of the brain, everything is much more serious: there may be a short-term loss of consciousness, vomiting begins (in children under 3 months - repeated), the skin turns pale, cold sweat appears. The child is lethargic, drowsy, refuses to eat; those who are older and capable of some information about themselves complain of headaches, tinnitus.

An even more severe injury is a contusion of the brain. In this case, immediately after the injury, a long blackout of consciousness is possible (sometimes it is absent for more than an hour). In especially severe cases, respiratory and cardiac disorders occur.

With a fracture of the skull, in addition to the general serious condition of the child, there may be an outflow of blood or a clear liquid (liquor) from the nose or ear, bruises form around the eyes (a symptom of glasses). It is very important to know that with skull fractures, symptoms do not appear immediately, but several hours after the injury.

Therefore, rule number one - after a bruise (damage) to the head, you must super-attentively monitor the condition of the child. Any doubt that “everything is in order” is a reason for immediate medical attention. If there are signs of concussion or brain injury, the doctor is called immediately.

What can be done?

If there is no obvious damage to the bones of the skull, moistened cold water cloth or ice in a rag. This will reduce pain, stop tissue swelling and bleeding.

Bleeding can be stopped in this way - by attaching a dense piece of dry matter (tampon) to the wound. If it becomes saturated with blood, put a second one on top of the first tampon. Attention! If bleeding continues after 15 minutes, call your doctor immediately.

After any head injury, the child needs rest, but do not let him fall asleep for an hour, otherwise you will not understand how bad his condition is. Wake up the baby at night. If he does not answer simple questions, or he has impaired coordination of movements, or vomiting is repeated, call a doctor urgently. Pay attention to the pupils: their unequal size indicates severe brain damage. If you suspect a serious injury, and the baby fell asleep, do not wait until he wakes up: call a doctor.

If the child has lost consciousness after hitting the head and you have already called an ambulance, lay the baby on its side so that the vomit does not enter the respiratory tract. If you suspect that, in addition to the brain, the spine has suffered (when falling from a height on the head or on the back), you must turn the child very carefully and so that the body and head are on the same axis: this will help avoid additional injury.

But still, the most important thing that is required of you if a child is injured is to remain calm. Too much depends on the adequacy of your reactions - the health of a small person depends.

Mom was distracted for literally a minute, but this time was enough for the child to fall and hit his head ... What should I do? How to determine the severity of the injury by external signs, and is it necessary to consult a doctor if, at first glance, nothing seems to bother the child?

The appearance of a child in the family requires constant attention and care from adults. And although, as a rule, all family members are well aware of this and are completely absorbed by the child, nevertheless, there are 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, a stroller). , from the hands of parents, etc.) and receive a traumatic brain injury.
What is a traumatic brain injury

Traumatic brain injury (TBI) is a mechanical damage to the skull and intracranial structures (brain, blood vessels, nerves, meninges).

The manifestations of traumatic brain injury in children differ significantly from the symptoms characteristic of adults, and they are due to the characteristics of the child's body, namely:
the process of ossification of the baby's skull is still incomplete, the bones of the skull are plastic, flexible, their connection to each other is loose;
the brain tissue is immature, saturated with water, the differentiation of the structures of the nerve centers and the circulatory system of the brain is not completed. Thus, on the one hand, the brain tissue has great compensatory capabilities and the so-called margin of safety (soft bones of the skull and more fluid in the brain than in adults can absorb a blow). On the other hand, since it is precisely the immature brain tissue that is subjected to injury, which can lead to a disruption in the development of its structures and provoke further restriction mental development, emotional disturbances, etc.
Classification of traumatic brain injury

According to one of the classifications, traumatic brain injuries are divided into:
Open TBI - head injuries, in which the integrity of the soft tissues, the bones of the skull is violated. If at the same time the dura mater is also damaged, then the wound 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 aggravates the injury.
Closed TBI - injuries to the head, in which the integrity of the soft tissues is not violated (or there are only minor abrasions, scratches) and skull bones. Most often, when falling from a height, children of the first year of life receive the closure of TBI.

1 Dura mater - one of the three membranes of the brain, external, adjacent to the inner surface of the bones in the cranial cavity, consisting of dense fibrous connective tissue; has a protective function.

In turn, closed injuries are divided into:
concussion (without division into severity);
mild, moderate and severe brain contusion;
brain compression.

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

Brain contusion (contusio) is a brain injury characterized by the occurrence of a focus / foci of destruction of the medulla of varying severity. Foci can be single, multiple, different in depth and location.

In this case, the patient develops neurological disorders (for example, the inability to follow moving objects with his eyes, etc.) and / or psychological changes.

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

Tiny cases of traumatic brain injury in infants
The baby lies on the changing table or on the couch, the mother turns away for a few moments, and the baby falls on the pop.
The baby is left unattended in a high chair. He kicks off the table with his feet and, together with the chair, falls on his back.
The baby is trying to get up in the crib. Something on the floor interested him, and he is hung over the side and falls.
The baby was left to sit in the stroller, not assuming that he would try to get up in it and, not finding support, would fall down.

External manifestations of head injuries

Since the relative weight of the baby's head is much greater than the weight of the body, when it falls, it first of all hits the head and more often the parietal region. Very rarely, the frontal and occipital regions of the head are injured.

After a fall, the child develops redness in the impact zone, the baby feels pain. If a pronounced rapidly growing edema does not appear in this place for several minutes, but only a slight swelling is noted, then as a rule, this indicates a bruise of the soft tissues of the head (which does not apply to TBI). It is necessary to apply something cold to the sore spot (a bubble with ice, 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 that time, for how long the baby will allow - often such a procedure causes an active protest). A cold compress will reduce tissue swelling that interferes with the normal functioning of the organ, narrow the blood vessels, which is the prevention of bleeding and will become an important factor in the favorable outcome of the injury in the future. The advantages of this procedure are more significant than the mythical possibility of hypothermia of the child during such short term. And most importantly, stay calm and try to calm the child.

External signs of concussion in children of the first year of life are rather meager. For infants, loss of consciousness on the background of a concussion is a rarity, in contrast to children of preschool and school age and adults. Nor can they complain of a headache. They just immediately begin to cry loudly, there is motor anxiety. After screaming, they can fall asleep. Waking up, they are capricious, refuse food. Then vomiting appears (usually single) or frequent regurgitation. On the first night after an injury, children do not sleep well. The more pronounced these violations in the behavior of the child and the longer they last, the more likely the concussion.

Another reaction to trauma is also possible: after sleep, the child's outward signs of trauma disappear and a false idea of ​​recovery is created. This is a dangerous delusion: the baby's condition can deteriorate dramatically.

If after the fall there was a long period of time (from one to several minutes) between the fall itself and the cry of the baby from the blow, most likely there was a loss of consciousness. The presence of such signs often indicates a brain injury. But sometimes in such a situation, parents lose track of time, it is difficult for them to navigate, a lot of time has passed since the child's fall or a little, there was a loss of consciousness or not. Even if the child just started screaming from the blow, but before that it was quiet for some time, this situation should alert parents, and it should be attributed to a more severe pathology. This will allow, without wasting time, to seek medical help and find out the severity of the injury. A contusion of the brain is accompanied by a violation of its blood flow of varying severity (from a decrease to a complete cessation), edema of the brain substance, hemorrhages in the brain, the development of paresis2 and paralysis3 is possible. Other signs of pathology are the same as in a concussion, but only more pronounced: repeated vomiting, prolonged anxiety, etc. In severe brain contusions, coma develops4.

2 Paresis (from the Greek paresis - weakening, relaxation) - a decrease in the strength and / or amplitude of voluntary movements, due to a violation of the transmission of nerve impulses to the corresponding muscles.
3 Paralysis (from the Greek. paralyo - to untie, relax) - a disorder of motor function in the form of a complete absence of voluntary movements due to a violation of the transmission of nerve impulses to the corresponding muscles.
4 Coma (from the Greek cat - deep sleep; synonymous with comatose state) - a state of deep depression of the functions of the central nervous system, characterized by a complete loss of consciousness, loss of response to stimuli and a disorder in the regulation of vital body functions.

If, during a brain injury, a hemorrhage occurred in its substance, then this leads to compression of the brain, in which damage to the vital centers of respiration and cardiac activity is possible, which disrupts their functioning up to the complete cessation of the body's vital activity. As a rule, depression of consciousness is noted in children with intracranial hemorrhages. The degree of impairment of consciousness may vary depending on the degree of brain damage - from severe drowsiness to coma.

When falling from a height in children, fractures of the bones of the skull (open TBI) are possible, which can also compress the brain. Fractures of the skull bones in infants are most often defined as cracks, these are the so-called linear fractures. According to their localization, length, width, one can judge the severity of the injury. Thus, the 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. These fractures also require surgery. A rapidly growing edema appears in the fracture zone, which may be the result of accumulation of blood in soft tissues (hematoma) due to damage to them by bone fragments. Often, it is the presence of such a swelling (bump) on the head of a child that makes parents see a doctor, while the very moment of injury or its other consequences go unnoticed.
What to do first if the child falls

We strongly advise parents whose children have suffered a head injury: even if, in your opinion, the baby is not bothered by anything, he fell from an insignificant height, stopped crying, etc., immediately seek help from the following doctors: a pediatric neuropathologist, a traumatologist, a neurosurgeon. To do this, you need to call an ambulance team at home and you and your child will be taken to a specialized hospital. Or, on your own, contact the emergency surgical department of any major children's hospital, where the indicated specialists will advise the child. If they do not confirm the pathology, it will be possible to safely return home.

Failure to see a doctor is dangerous due to late diagnosis of injury, aggravation of the child's condition, and the possibility of coma. All this requires treatment in intensive care, in some cases - surgery. Seeing a doctor late increases the risk of death, complications, lengthens the recovery period and worsens its outcome, to the point that the child may become disabled.
Where is TBI treated?

By existing rules(standards), all children with traumatic brain injury should be hospitalized. Children with a concussion (a 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 available in a particular region).

Carrying out reasonable targeted treatment requires a comprehensive examination of the child, which is possible only in a hospital.

This examination includes thorough examinations of the nervous system, vestibular apparatus, organs of vision, hearing, and other studies.

In the admission department, the child is examined, signs are identified that indicate damage to the bones of the skull or brain injury, parents are asked about the condition of the child after a fall, etc.
Methods for diagnosing TBI

An important examination for head trauma in infants is neurosonography - an examination of the structure of the brain using an ultrasound machine through the child's large fontanel (such a study is possible until the large fontanel closes, up to 1 - 1.5 years). This method is easy to use, does not have a negative effect on the body, provides enough information to determine the tactics of treating 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 of its use may be the lack of an ultrasound machine in the hospital or a specialist who can work on it (for example, not all hospitals in the country with ultrasound machines can perform emergency neurosonography at night, since the specialist works during the day).

If an intracranial hemorrhage is suspected (especially if, for various reasons, it is not possible to do neurosonography), a lumbar puncture is performed - therapeutic and diagnostic manipulations, in which a hollow needle connected to a syringe is punctured in the region of the second-fourth lumbar vertebrae of one of the spaces of the spinal cord (subarachnoid space) and taking a portion of cerebrospinal fluid for examination under a microscope. By the presence of blood cells in the cerebrospinal fluid, the presence of intracranial hemorrhage is judged.

In addition, there are more sophisticated methods for examining a child's head: computed tomography (CT) and magnetic resonance imaging (MRI).

Computed tomography (CT) (from Greek tomos - segment, layer + Greek grapho - write, depict) is a research method in which images of a certain layer (slice) are obtained using x-rays human body(e.g. heads). With CT, the rays fall on a special device that transmits information to a computer that processes the received data on the absorption of x-rays by the human body and displays the image on the monitor screen. Thus, the smallest changes in the absorption of rays are recorded, which, in turn, allows you to see what is not visible on a conventional x-ray. It should be noted that the radiation exposure with CT is much lower than with conventional X-ray examination.

Magnetic resonance imaging (MRI) - a diagnostic method (not associated with x-rays), which makes it possible to obtain a layer-by-layer image of organs in various planes, to build 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 radiate 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 the 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 and early childhood difficult because of the need to conduct this examination in children in a state of immobility (under anesthesia), since important condition the success of the technique is the immobility of the patient, which cannot be achieved from the baby.
TBI treatment tactics

After the examination and clarification of the diagnosis, the tactics of treatment are determined. Drug treatment is prescribed (therapy aimed at eliminating cerebral edema, lowering intracranial pressure, correcting metabolism and blood flow in the brain, etc.). Surgical treatment is used (and necessary) primarily to eliminate compression of the brain. It is prescribed for children with depressed skull fractures and intracranial hemorrhages.

Parents need to realize that only a comprehensive, adequate examination of the child allows you to correctly and timely treat a brain injury, achieve recovery and avoid disability.
Consequences of TBI

Research on the problem of traumatic brain injury shows that even a minor injury can cause undesirable consequences.

Under the influence of trauma (the moment of mechanical damage to the substance of the brain) and its consequences, the functions of various parts of the brain are disrupted, and, consequently, the work of organs and systems subordinate to them (endocrine, digestive systems etc.). Blood flow may be disturbed, including the outflow of venous blood from the cranial cavity. The regulation of vascular tone suffers - they can narrow inadequately, leading to an increase blood pressure. All this impairs the course of 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 exist, certain brain functions fall out. For example, the frontal lobes are responsible for intelligence, which means that the presence of cysts in this place reduces it. In addition, it is known that the normal brain inside and outside has spaces filled with cerebral (cerebrospinal) fluid. After an injury, it can accumulate excessively in them - and therefore, intracranial pressure increases. The fluid under pressure compresses the substance of the brain, causing its slow atrophy5 (this phenomenon can also occur during the formation of cysts).

The triggering of the pathological mechanisms of an injury depends on its severity: the more severe it is, the more pronounced the violations, the worse the outcomes, the longer the recovery period.

5 Atrophy (from the Greek atrophia; a - lack of a sign or quality, trophe - nutrition) - a decrease in the mass and volume of an organ or tissue as a result of an eating disorder, accompanied by a weakening or cessation of their functions.

With mild traumatic brain injury, the prognosis is usually favorable - subject to the recommended regimen and treatment. After recovery, asthenization phenomena are possible - the child quickly gets tired, becomes inattentive, irritable. In this case, the baby is more inhibited, which can lead to repeated injuries. These developments may have an impact on intellectual development child.

With TBI of moderate severity, an increase in intracranial pressure, frequent headaches, and impaired coordination may join the asthenization phenomena.

In severe TBI, the prognosis may be unfavorable - mortality in these cases reaches 15-30%. After recovery, a wide variety of consequences are possible: from varying degrees of motor disorders, pronounced convulsive seizures to gross mental disorders, consciousness, which leads to disability.

With open TBI, purulent-inflammatory complications often occur (for example, meningitis - inflammation of the meninges, 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 mild TBI. It was believed that after such an injury, recovery occurs within a few days, a maximum of 2-3 weeks. But studies have shown that 1-3 months after a concussion, at least half of the children have some or other 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 state of health of the child.

Among the various injuries of the body, head injuries account for 30-50% of all injuries in children. And every year this figure increases by 2%.
How to reduce the likelihood of TBI

Injuries in children happen most often 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 idea of ​​the motor skills of the baby. Parents should provide for the emergence of new motor skills in the child and take safety measures.

So, month old baby, lying on his stomach, can push off with his feet from the side of the changing table, from the back of the sofa, bed and fall. Every next skill or movement of the baby (attempts to sit, crawl, stand) can also lead to "unexpected" injuries. A child, trying to get up, may fall out of the stroller, out of the child's chair, especially if they forgot to fasten it.

If you need to move away, do not leave the child alone lying on any high (and not very) surface, put the baby in a crib, playpen, or even on the floor.

Secure your child in the highchair and stroller.

If your home has stairs, put up a safety rail to prevent your baby from falling down or climbing high and then falling.

“Walkers” can also be unsafe: children, being in them, can strongly push off, hit something, roll over, and also fall down the stairs. It is better to refuse to use such a vehicle.

"Jumpers" are dangerous because of the unpredictability of the trajectory of movement: for example, a child in them may collide with a wall.

The most important role in reducing child injuries is given to prevention, and the main thing in it is the attentive attitude of adults to children and their safety.

Quite often, babies roll off the tables where they are swaddled, so the procedure is best performed in a safer place, for example, on the couch. It is necessary to foresee a possible fall and lay a carpet next to the sofa.

2 Older child

For safety, the child needs to buy socks that have rubber inserts in the sole, they reduce slipping and the child will not fall on the slippery parquet floor. It is recommended to spread rugs in the children's room. In addition, it is advisable to wrap the sharp corners of all furniture and door jambs with a cloth. It is necessary to remove chairs or a table from the window so that the baby cannot climb onto the windowsill.

3 If the child fell

If the child fell and hit his head, do not immediately panic, you need to concentrate on controlling the consequences of the injury.

If the injury is mild and the brain is not damaged in any way, the child has only a small abrasion or bump. The baby cries for half an hour, then calms down and behaves in the usual way. In this case, there is no need to consult a doctor.

If a concussion occurs, then the child may experience such processes as loss of consciousness, vomiting (up to 3 months of age), pale skin, and the presence of cold sweat. The child's appetite worsens, drowsiness and lethargy appear. If he is older, he may complain of pain in the head and tinnitus.

One of the most severe injuries is. In such a situation, the child may lose consciousness for a long time (more than 1 hour), there may be disturbances in the functioning of the organs of the respiratory and cardiac systems.

If a child has a skull fracture, you may notice blood from the nose or ear, and bruising around the eyes may also occur. These symptoms appear a few hours after the fall.

The most important rule is to carefully monitor the behavior of your child after an injury. If there are doubts about his positive health, then you should consult a doctor.

4 What can you do yourself?

If there are no serious injuries to the skull, a cloth moistened with cold water should be applied to the impact site, ice can also be wrapped in a cloth. This procedure helps to reduce pain, stop bleeding and reduce swelling.

Bleeding can be stopped by another method - attach a dense piece of dry, clean tissue to the sore spot. If blood appears on it, then another layer of matter should be added and held for 15 minutes. If after a while the bleeding has not stopped, then you should immediately call a doctor.

After the injury, whatever degree it may be, the child should be provided with calm, but not allowed to sleep for an hour in order to understand exactly what consequences he has after a fall.

If the child is unconscious after the injury, the ambulance is already on its way, then you should lay him on his side so that the vomit does not enter the respiratory system. If there is a suspicion that, in addition to the head, the child has a spinal injury (for example, when falling from a height), then it must be turned very carefully so as not to cause additional injury.

When a child appears in the family, adults must constantly control all his actions and take care of him. In our life, there are very often cases when a child falls out of a stroller, his bed, etc., while receiving a traumatic brain injury. It is necessary to foresee all possible outcomes of events and make sure that the child does not hit his head on heavy objects.

Such injuries are of 2 types: open and closed. Open means violations of the meninges. When the hard shell is broken, the injury is called penetrating. In such a situation, the child's brain is under great threat. Infection is possible, which will greatly aggravate the condition of the child. A closed craniocerebral injury carries milder consequences, since the head cover remains intact.

Closed injuries come in 3 degrees of difficulty: mild, moderate and severe. To determine severity, the Glasgow coma scale must be used. If a child on such a scale received from 13 to 15 points, then the injury is mild, if from 9 to 12, then the degree is average, and if from 3 to 8, then the degree is complex.

First of all, you need to contact a pediatric traumatologist, a neuropathologist and a neurosurgeon. If you do not resort to the help of specialists in time, the child may experience a coma, the risk of death increases. Severe injuries are treated exclusively in a hospital.

To diagnose a traumatic brain injury, it is necessary to undergo neurosonography. During this study, the structure of the brain is subject to examination. This method is used for a patient from 1 to 1.5 years.

5 Treatment and consequences of traumatic brain injury

The specialist, after the diagnosis is made, prescribes medication.

It includes drugs that help eliminate, help reduce intracranial pressure, correct metabolism, etc.

You can improve cerebral blood flow with the help of drugs such as Cavinton, Complamin, etc. The use of ascorbic acid will help strengthen the vascular wall, and Reserpine or Raunatin will cope with the normalization of vascular tone, which are prescribed only by a specialist in the correct dosage.

If the injury is mild, all the recommendations of the doctor were followed, then after recovery, sometimes only a feeling of fatigue and irritability may occur. The child becomes a little inhibited, there is a tendency to repeat the injury. Such phenomena may cause failures in his intellectual development in the future.

Mortality in such injuries is quite high and reaches 30%. After them, children often have disorders in the functioning of the organs of the musculoskeletal system, there are deviations in the psyche, in the future the child may become disabled.

If there was an open form of injury, then inflammation of the membranes of the brain may occur, such a process most often ends in death.

6 Prevention of childhood injuries

In infancy, you should constantly monitor all the actions of the child. AT game form it is necessary to explain to him how to take care of himself and what not to do.

If a child is involved in any sports section, he should follow the safety instructions of his coach.

AT winter time a year, a child can slip and fall on ice, so parents should provide him with high-quality shoes with a reliable tread.

Parents should not leave their child younger age unattended in any situation as long as it is prone to injury.

Perhaps there is no such child who has never fallen and hit his head. This is especially true for babies who are learning to crawl or walk. At this age, small falls and bruises are inevitable. The task of parents is to ensure maximum safety for the child and teach him to properly coordinate his movements.

However, there are situations when, after a fall and a blow to the head, a child may experience alarming symptoms that indicate a head injury. In this case, it is necessary to show the child to the doctor as soon as possible. What should you do if your child has fallen and what should you pay attention to in the first place.

How dangerous are head blows in young children?

Many parents may recall that their children, when they were young, kept falling and hitting their heads. After all, at first the baby learns to sit and cannot always keep his balance, then he learns to crawl and walk, not always deftly and quickly gets up. And the head, as the heaviest part of the body, takes most of the blows on itself.

Yet it provided by nature, since children have large and small fontanelles on their heads, it is thanks to them that the blow is amortized and does not always pose a danger to the health of the baby. In addition, in younger children, there is more fluid between the bones of the skull and the brain than in adults. It also performs a protective function for the child.

Therefore, most of the blows and falls for the child end safely. However, parents need to know which signs and characteristics of the child's behavior may indicate and require immediate medical attention.

Inspection of the impact site and first aid

If your child has fallen and hit his head, the first thing to do is examine the impact site and try to qualify the severity of the damage.

• A lump (hematoma) formed at the site of impact. In this case, first of all, a cold compress should be applied - it can be any fruit or a bag from the refrigerator, or a bottle of chilled liquid. Try to hold the compress on the bruised area for at least 3-4 minutes, this will help prevent severe swelling.
• A wound formed at the site of impact and blood flows from the abrasion. Moisten a cotton swab or gauze pad with hydrogen peroxide and apply it to the abrasion to prevent infection. If after ten minutes the bleeding has not stopped, call an ambulance!
• There is no visible damage at the impact site.. In this case, you only have to carefully monitor the child's condition for 2-3 days and note uncharacteristic behavior for him. This may be excessive, drowsiness, complaints of headache, excessive tearfulness, and so on.

Before seeing a doctor, do not give your baby no painkillers, as this will significantly complicate the examination of the child.

Immediately after the injury, try not to give baby fall asleep, since in this case you will not be able to fairly objectively assess his condition.

Provide your child peace, do not play outdoor games. Let the child lie quietly on his side.

Warning symptoms after hitting your head: when to see a doctor

In any case, after any head injury, it is necessary watch the child especially carefully - a few hours after the impact, and pay attention to his well-being for another two to three days.

What symptoms should be looked out for? If you notice one or more of these signs of a traumatic brain injury, contact your doctor immediately. Of course, this may be just a coincidence, but this case, it is better to play it safe in order not to lose time if the child needs treatment.

• Drowsiness, lethargy, lethargy
• Tearfulness uncharacteristic for a child
• Different sizes of pupils of the eyes
• Episode of loss of consciousness immediately after impact
• Vomiting or child's complaints
• For infants - frequent and uncharacteristic regurgitation
• Dizziness, inability to balance
• Complaints about tinnitus
• Bleeding from the nose or from the ears
• Lack of appetite or complete refusal to eat
• Bad disturbing dream
• Speech or hearing disorders in a child, complaints of poor vision
• Paleness of the skin
• The appearance of bruises under the eyes

Possible injuries and consequences of hitting the head in a child

Traumatic brain injuries that a child could have received during a fall are divided into open and closed.

To closed injuries in turn are

• brain compression
• brain contusion
• brain concussion

The most serious damage is compression- in this case, a bruise may be accompanied by rupture of blood vessels, with a bruise foci of destruction of the substance of the brain are observed. Shake the brain is the easiest injury. In this case, the brain is not damaged, and at the site of impact, we can detect a hematoma or bruise.

Prevention of head injuries in children (VIDEO)

Babies under one year old often fall off beds, sofas, or changing tables. Never leave them unattended at a height from the floor! Even if the child is not yet able to roll over or crawl, he can reach the edge of the table or bed and fall headfirst. If the baby already knows how to roll over, crawl, then it is safest to leave him on the floor. Lay out a rug or a diaper for him and put it down if you need to go away on business. In this case, you can be sure of its safety. Children fall off the couch most often when their mothers leave them "just for a minute." On the changing table, always hold the baby with one hand. If you need to go away or even turn away for a diaper or powder, take your baby with you.

Children in their early years study the world very actively. But the lack of experience makes itself felt and sometimes the study ends with injuries, including head injuries, the consequences of which can be very different, and the symptoms are often incomprehensible and even contradictory.

Babies under one year of age fall very often, mostly rolling off changing tables when the parent turns away for literally one second. The main reasons for such falls are the extreme curiosity and mobility of the child, the inability to control his body and a large specific gravity heads.

The safety rules to prevent such situations are very simple:

1. Even if you turn away for a moment baby you need to transfer it to a crib with sides, or take it with you, then there will be no risk that the newborn will hit his head
2. It is desirable that the changing table be low
3. It is better to put a soft carpet down on the floor, because even with safety precautions, the baby is not 100% safe from falling
4. It is possible to put the child on this carpet during absence, if the floor is warm and safe enough
5. When changing diapers, you need to additionally hold the baby with your hand

Babies also fall from sofas and armchairs, when mom or dad went away for a minute, and also fall out of strollers. Therefore, you need to pick up a stroller with high sides, it itself should be low, and the “passenger” must be fastened so that the child does not hit his head on the asphalt. Falls also occur when the baby, sitting on a high chair at the table, pushes off from him with his feet and, together with this chair, pushes back.

Children a little older can fall from a sitting or standing position, and children 3-5 years old often fall from swings, ladders, trees, just while running and outdoor games. At the same time, after the age of five, the number of head injuries in children is markedly reduced.

Effects

Situations when a child fell and hit his head are quite dangerous in infancy, because the baby is still forming the bones of the skull, the connections between them, the brain, cerebral vessels and nerves. True, sometimes such a “softness” of the head can absorb a blow, but you should not count on it. But the negative consequences can be very serious, reaching the emotional and mental lag in development.

The most harmless type of head injury is, of course, simple bruises and bumps. In fact, this is the only situation in which the help of a doctor is not required. In second place is a concussion, which occurs in 9 cases of falls out of 10. The next in severity are brain contusion and compression of the brain, resulting in rupture of blood vessels. And finally, the most dangerous head injury in a child is an open craniocerebral injury, in which the meninges are damaged (for example, by broken bones of the skull). It heals very hard and is accompanied by the threat of infection.

Symptoms

The symptoms of trauma when a child falls and hits his head are quite different from the symptoms in the same situations in adults. With a concussion, children lose consciousness for a short period, but it is not so easy to notice in infants, so you need to detect how long after the fall the child began to cry. If at least a minute has passed, then we can conclude that a loss of consciousness occurred.

Other symptoms of concussion in children:

• pale skin
• cold sweat
• vomiting (including repeated)
• loss of appetite
• such a contradictory situation as drowsiness with a simultaneous sleep disorder can be observed.

Signs of a brain injury: loss of consciousness up to 60-70 minutes or more, respiratory and heart failure. When the bones of the skull are fractured, a clear liquid, the so-called cerebrospinal fluid, can flow out of the nostrils or auricles, and bruises appear under the eyes. These symptoms may appear immediately or some time after the injury.

In older children, the degree of brain damage can be tested by asking various simple questions and watching their reactions, as well as by giving them a small “test” on their coordination of movements. The speed of response to the question and the adequacy of motor reactions directly characterize the severity of the child's condition. Children of this age should avoid excessive visual load during rehabilitation after an injury.

When to See a Doctor After a Baby Falls

The main signs in which you need to see a doctor if the child hit his head:

• deterioration of health, the baby "falls asleep on the go"
• muscle twitching, leg cramps
• pupils that do not constrict in bright light or pupils that are unequal in size
• severe blanching of the skin
• muscle paresis or paralysis
• in older children - dizziness
• blood in urine, stool, or even vomit

The only consequences of a fall that do not require a doctor's call are the usual bumps and abrasions. However, it is worth noting that seeking professional help is still required if the fall occurred from a height exceeding 1 meter. As a rule, after the examination, the doctor decides whether it is possible to continue treatment at home, or whether additional diagnostics and hospitalization are necessary.

Diagnosis of a child, as a rule, includes:

1. Computed tomography of the brain
2. Neurosonography - a study of the baby's brain using ultrasound with a frequency of 5000-7500 Hz through an open fontanel. The procedure allows you to establish the fact of hemorrhage, as well as determine the amount of intracranial pressure.

Before the doctor arrives, you can give the baby first aid, but you need to be extremely careful. After hitting his head, the child needs peace (however, at first it is better not to let him sleep) and the absence of irritants: bright lights and toys, loud sounds, pungent odors.

It is good to apply compresses from a towel soaked in cold water to the cones. If blood starts to flow, then it can be stopped with a cotton or paper swab, you just need to remember that with prolonged bleeding (more than a quarter of an hour), you need to see a doctor.

The situation when a child hit his head is very unpleasant, but not critical. Compliance with safety precautions will reduce the event of a fall to a minimum, and with timely contact with a specialist, the negative consequences of such excesses can be completely avoided.