From the Guidelines
If your child has suffered a head injury, it is crucial to monitor them closely for the next 24-48 hours and follow the instructions provided by a healthcare professional, as outlined in the Centers for Disease Control and Prevention guideline on the diagnosis and management of mild traumatic brain injury among children 1. When monitoring your child, watch for warning signs that require immediate medical attention, such as:
- Persistent vomiting (more than twice)
- Severe headache unrelieved by acetaminophen (Tylenol)
- Unusual drowsiness
- Difficulty waking
- Confusion
- Slurred speech
- Seizures
- Weakness in arms or legs
- Unequal pupil sizes For mild symptoms, you can give acetaminophen (Tylenol) for pain relief at the appropriate dose for your child's weight (typically 10-15 mg/kg every 4-6 hours), but avoid ibuprofen (Advil, Motrin) initially as it may increase bleeding risk, as suggested by the American Academy of Pediatrics 1. It is essential to allow your child to rest, but it's not necessary to keep them awake if they're tired. Wake them once during the night to ensure they respond normally. Most children recover completely from minor head injuries within a few days. Apply ice wrapped in a cloth to reduce swelling for 20 minutes at a time. Gradually return your child to normal activities as symptoms improve, but avoid rough play or sports until they're symptom-free for at least a week, as recommended by the clinical practice guideline recommendations in pediatric mild traumatic brain injury: a systematic review 1. The brain needs time to heal, and a second injury before full recovery can cause more serious damage. Always consult your doctor if you're concerned about your child's condition.
From the Research
Head Injury in Children
- Head injury in children is one of the most common causes of death and disability in the US and worldwide 2
- Classification of head injury in children can be organized according to severity, pathoanatomic type, or mechanism 2
- Response to injury and repair mechanisms appear to vary at different ages, and these may influence optimal treatment 2
Reye's Syndrome and Aspirin Use
- Reye's syndrome is a serious, acute encephalopathy that has been linked with aspirin use in children and teenagers <18 years of age 3
- The evidence suggests a close link between Reye's syndrome and ingestion of aspirin during the febrile prodrome, with the drug appearing to act as a co-factor in susceptible individuals 3
- Studies have shown a dose-response relation between risk of Reye's syndrome and dose of aspirin ingested during the antecedent illness, providing further supportive evidence for a causal link between Reye's syndrome and aspirin 4
- The use of aspirin in children has been linked to an increased risk of Reye's syndrome, and the decline in aspirin use has been accompanied by a dramatic decline in the incidence of Reye's syndrome 4, 5
Prevention and Education
- Educating adolescents and parents of older children about Reye's syndrome and cautioning against the use of aspirin to treat influenza, upper respiratory infections, or varicella is crucial 5
- Government health warnings have been effective in reducing the incidence of Reye's syndrome, and continued education and awareness are necessary to prevent the disease 3, 4