Traumatic head injury is a common occurrence in the
paediatric population, with the majority of patients
sustaining only mild head injury.
This article outlines the management of mild head injuries
A careful history including time of injury, the mechanism
of injury, and any loss of consciousness or seizure activity;
a thorough examination including a Glascow Coma Scale
(GCS) score; and observation should be appropriate for
most patients. Only a small number of injuries require
further examination/imaging with computerised
tomography. Indicators for transfer to hospital include GCS
equal to or less than 12, focal neurological deficit, clinical
evidence of skull fracture, loss of consciousness for more
than 30 seconds, ataxia, amnesia, abnormal drowsiness,
persistent headache, seizure following initial normal
behaviour or recurrent vomiting. Postconcussive symptoms
frequently occur after minor head injuries and parents and
other family members should be aware of what symptoms
to expect, and possible duration. Regular follow up until
all symptoms have resolved is mandatory, with clear
guidelines for stepwise resumption of physical activity.
Although head injury (HI) is common within the paediatric population, no accurate data exist for the true incidence of HIs within this population subset in Australia. For the management of HIs, all those aged 16 years or less are considered to be part of the paediatric population.
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