Two weeks ago we took a trip to San Diego so my husband could attend a conference and Eli and I could play by the ocean. On the last day we were there, I was hanging out in our hotel room, trying to keep Eli awake just a little while longer when it happened. We were sitting on the hotel bed, I bent over to get his pacifier and before I could blink, Eli hit the floor head first.
It was apparent from the moment of the injury that he wasn’t okay. He couldn’t hold his head up, wouldn’t open his eyes, and was moaning in pain. We ended up going to a local children’s hospital by ambulance, which is a situation I never thought we’d be in. Once at the hospital, they looked at Eli’s head and neck, took a neck x-ray and said he was fine, but that he might have a sore neck. We were told that kids fall off furniture all the time and to not worry, just give him some Motrin and he’d be okay.
But he wasn’t.
Later that day, Eli began profusely vomiting and having trouble staying awake. We went to a different hospital where a CT scan showed that he had a subdural hematoma. It’s a fancy way of saying that he was bleeding on his brain. It’s true that kids fall off beds and changing tables every day and the majority of them are fine, but my son got much more than a bump on the head, he got a mild traumatic brain injury. Since being discharged from the hospital last week he’s had a few mild seizures and continues to vomit periodically, but thankfully, he’s otherwise pretty much back to normal. We were lucky.
Thankfully we knew when to return to the hospital because this particular injury, and several other types of head injuries, have a high rate of morbidity and mortality when left untreated. In light of what we learned, I thought I’d share a few signs that you should take very seriously when it comes to head injuries in people of all ages so that hopefully none of you face that period of uncertainty that we did:
Loss of Consciousness
This can be either at the time of the injury or later that same day. Eli never lost consciousness after the initial injury, but he had difficulty staying conscious later that day, which was a big sign to us that something was not okay.
Blood and pressure on the brain can result in repeated and intractable vomiting. Often the person doesn’t even feel particularly nauseous, but they vomit anyway, and anti-nausea drugs are relatively ineffective for this type of vomiting. Vomiting after head injury should be treated seriously, even if your child (like mine) has a sensitive gag reflex.
Kids tend to want to sleep after something traumatic, but there’s a line where normal nap or stress related sleepiness becomes head injury sleepiness. Eli slept 6 out of 7 hours the afternoon of his injury, which was decidedly outside the realm of normal for him.
Pupil Size Differences
When there’s a serious injury to the brain, the eyes may be a big sign. In fact, it’s one of the first things your doctor will check. One eye may respond to light differently than the other, or the pupils may just be different sizes without any change in lights. This is an emergency and should be treated accordingly.
It can be hard to tell if a baby is confused (I’ve found that they often act like drunk adults), but in older kids, changes in speech, difficulty with word finding, difficulty with normal daily activities may be a sign of confusion. For adults, not knowing the date, time, location or something that took place earlier in the day may be a sign that something serious is going on.
Sometimes there aren’t any outward signs, but there’s that nagging gut feeling that something isn’t okay. Even if Eli hadn’t showed many of these signs later in the day of his injury, I’d have probably taken him back to a doctor that day because in my gut, I knew that it was more than just a bump and a sore neck. Never ignore your intuition, it can be one of the most valuable medical tools. And if you’re not getting the care you think you need, seek a second opinion.
It goes without saying that another big part of this is to be incredibly careful on high surfaces or avoiding them all together with small children. Eli’s injury happened in the blink of an eye and I was within inches of him at the time. Keep your babies off high beds and strap them into the changing table whenever possible. Never leave babies unattended on any surface off the floor unless they’re buckled in, and even then, only if they’re within view.