Bump on the head: When is it a serious head injury?

    Recently, my daughter got kicked in the head during a soccer game. She seemed fine at the time, but later developed a sizable lump on her forehead. Is this a concern?

    Probably not. Head trauma from play or sports is a common concern for parents, but rarely does a bump on the head result in serious injury.

    The forehead and scalp have a large blood supply. Injury to these areas often results in bleeding under the skin. When the bleeding is in just one area, it causes bruising and swelling, known as a hematoma. Keep in mind that even a minor head bump can cause a large swelling.

    The speed, momentum and size of the children involved, such as teenagers versus young children, can increase the possibility of a serious injury. The forces involved, such as impact with a concrete floor or hard surface, also can raise the risk of a serious injury.

    When to see a doctor

    The American Academy of Pediatrics recommends that you call a member of your child's healthcare team for anything more than a light bump on your child's head.

    If your child remains alert, moves as usual and responds to you, the injury is probably mild. A mild injury usually doesn't need further testing.

    Occasionally, a blow to the head may be bad enough to cause bleeding in or around the brain. This type of bleeding can cause an intracranial hematoma, a serious condition that puts pressure on the brain.

    See a healthcare professional within 1 to 2 days of a head injury with ongoing symptoms, even if emergency care isn't required.

    Seek emergency medical attention if your child experiences:

    • Loss of consciousness, confusion or disorientation after a head injury.

    Also seek emergency attention if your child has the following symptoms after a head injury, which could signal a concussion:

    • A headache that is getting worse.
    • Trouble with balance.
    • Vomiting.
    • Blood or clear fluid coming from the nose or ears.
    • Memory loss or confusion.
    • Mood changes, such as being irritable.
    1. Meehan SP, et al. Concussion in children and adolescents: Clinical manifestations and diagnosis. https://www.uptodate.com/contents/search. Accessed March 22, 2024.
    2. Lumba-Brown A, et al. Centers for Disease Control and Prevention guideline on the diagnosis and management of mild traumatic brain injury among children. JAMA Pediatrics. 2018; doi:10.1001/jamapediatrics.2018.2853.
    3. Schutzman S. Minor head trauma in infants and children: Management. https://www.uptodate.com/contents/search. Accessed March 22, 2024.
    4. Symptoms of mild TBI and concussion. Centers for Disease Control and Prevention. https://www.cdc.gov/traumaticbraininjury/concussion/symptoms.html. Accessed March 22, 2024.
    5. Concussion signs and symptoms. Centers for Disease Control and Prevention. https://www.cdc.gov/headsup/basics/concussion_symptoms.html. Accessed March 22, 2024.
    6. Schutzman S. Minor blunt head trauma in children (2 years and older): Clinical features and evaluation. https://www.uptodate.com/contents/search. Accessed March 22, 2024.
    7. Sports-related concussion. Merck Manual Professional Version. https://www.merckmanuals.com/professional/injuries-poisoning/traumatic-brain-injury-tbi/sports-related-concussion#. Accessed April 3, 2024.
    8. Halstead ME, et al. Sport-related concussion in children and adolescents. Pediatrics. 2018; doi:10.1542/peds.2018-3074.
    9. Head injury. Pediatric Care Online. https://publications.aap.org/pediatriccare. Accessed April 3, 2024.
    10. Minor head injuries in children. Pediatric Patient Education. https://publications.aap.org/patiented. Accessed April 4, 2024.

    FAQ-20058442


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