• A concussion is a jarring injury to the brain. The person may feel dazed and may lose vision or balance for a while after the injury.

• A brain contusion is a bruise of the brain. This means there is some bleeding in the brain, causing swelling.

• A skull fracture is when the skull cracks or a crack in the bone. Sometimes the edges of broken skull bones cut into the brain and cause bleeding or other injury.

Bleeding in the brain that collects and clots, forming a bump or known as a haematoma - may not be apparent for a day or even as long as couple of weeks. So it's important to tell your doctor if your child with a head injury feels or acts out of character or strangely. Keep observing and watch out for headaches, listlessness, balance problems or vomiting.

How bad is the damage?
Your doctor will ask about how the injury occurred, about past medical problems, and about vomiting, seizures (fits) or problems breathing after the injury.

The injured child may need to stay in the hospital to be watched. Sometimes, CT scans and other special pictures of the brain may be needed to find out more about the damage.

What happens after the injury?
Your child may have a headache and nausea, and feel dizzy right after a head injury. Other symptoms include ringing in the ears, neck pain, and feeling anxious, upset, irritable and tired.

The child who has had a head injury may also have problems concentrating, remembering things, putting thoughts together or doing more than one thing at a time.

These symptoms usually go away in a few weeks, but may go on for longer if the injury was severe.

Will the head injury cause permanent brain damage?
This depends on how bad the injury was and how much damage it did. Most head injuries don't cause permanent damage.

It's common for someone who's had a head injury to forget the events right before, during and right after the accident. Memory of these events may not come back. Following recovery, the ability to learn and remember new things almost always returns.

If the doctor at the hospital sends you home you will be given a card with a list of signs and symptoms to look out for over the next few days / weeks. If you see changes then go back to the hospital it could be serious.

• Any symptom that is getting worse, such as headaches, nausea or sleepiness
• Nausea that doesn't go away
• Changes in behavior, such as irritability or confusion
• Dilated pupils (pupils that are bigger than normal) or pupils of different sizes
• Vision problems
• Trouble walking or speaking
• Drainage of bloody or clear fluids from ears or nose
• Vomiting
• Seizures or convulsions

By: Peter Sommer RN (UK) – Director Training Division Asia Medical Services Ltd.