Sunday, 31 March 2013

Baby head injuries for dummies

Well, it finally happened. After about 9 months of Ryder sleeping in our bed (somewhere around 10 months old he started refusing to go back into his cot at night, and I was too tired to care...), he fell off.

It wasn't the way I expected it to happen: accidentally rolling off the bottom of the bed in the middle of the night. Instead, he threw a little tantrum when he woke up from a nap in Sri Lanka and I wouldn't let him proceed to rip the mosquito net to shreds. His favored type of tantrum involves flinging himself with much gusto onto his back and kicking wildly. In this instance, he started out too close to the edge and flung himself off the bed and onto the tile floor.

Almost immediately, a big bump swelled up on his scalp. I knew three things:
(1) I should put an ice pack on his head.
(2) There was no way in hell he would let me put an ice pack on his head.
(3) I was supposed to do something involving looking at his eyes to check for serious problems.

Instead, because we were all hungry and I didn't really know what to do, we went out to lunch. There was another little toddler at the restaurant to play with, but instead of his normal behavior, Ryder became clingy, possessive, and mean to the little girl. When she took his toy car, he pulled her hair. When her mom picked him up for a cuddle, he cried and kicked and reached for me like the world was ending. But then he was fine for a while, introducing himself to everyone at the restaurant as usual.
Making new friends, even while super grumpy

Still, his extra-grumpy behavior and my lack of knowing what I was supposed to keep an eye on made me worried. After giving him a dose of Panadol (not sure why I didn't do that first), I walked a few blocks to the local doctor.

I was happy that he spoke excellent English, gave me a fantastic explanation about head injuries, and a drawing to take home. Here is what I learned (for less than $2):

(a) There is a network of thin blood vessels between the brain and the skull
(b) If the head is hit hard enough, the brain sloshes around and can pop these blood vessels
(c) If blood starts to collect, it doesn't have anywhere to go, since the skull is rigid, so it presses into the brain
(d) That is not good
Cross-section of the head. The hashed bit is the brain, and the scribbly bit is blood pushing on the brain.
So, what to do?

Apparently, look for these signs:

(a) Vomiting = not good, go to hospital
(b) Other extreme problems (difficulty walking, etc.) = not good, go to hospital
(c) If the kid seems otherwise relatively normal (aside from likely headache [Panadol is useful for that, duh]), check that both pupils respond to light by getting smaller, approximately every 30 minutes for 24 hours. If they stop behaving properly = not good, go to hospital

Happily, Ryder didn't have (a) or (b), so I only had to do (c)...but it was kind of a lot of work, and I have to admit I didn't do it every 30 minutes. But I did manage a check every hour or so during the day and even several times at night (you can pull open his eyelid and shine a light in my baby's eyes in the dead of night without waking him up! creepy!).

I hope that is helpful next time your child slams his own head with the door (yes, he did that this morning), or otherwise injures his head to the point where you are worried about concussion. Just remember that I am not an actual medical doctor, so the best thing to do if you are really worried is to go see your local GP or hospital.

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