Skull fractures
Haemorrhage (bleeding) following head injury
Possible complications of head injury
Monitoring your child
Assessing a child’s head injury
- X-rays allow us to see any fractures in your child’s skull. Your child will have to lie still for a few moments while the x-ray is taken.
- Computerised tomography (CT) scans show us a cross section of your child’s brain and allows us to see any injured areas. Your child will have to lie still for about a minute on a narrow bed that slides into a scanner. The machine is slightly noisy. Sometimes we need to inject a dye into your child’s bloodstream via a cannula to give us a clearer picture, but this is not always the case.
- Magnetic resonance imaging (MRI) scans are similar to a CT scan but it is very noisy and can take up to two hours, so if your child needs an MRI scan they will probably be sedated or given a general anaesthetic. An MRI scan gives us a highly detailed, multi-layered picture of the brain. It is not always needed in the early stages of a head injury.
- Intra cranial pressure (ICP) monitoring involves the insertion of a fibre optic sensor onto the surface of the brain or dura. The sensor is attached to a monitor that allows us to see the pressure caused by any swelling within your child’s skull. The sensor is put in while your child is sedated or under general anaesthetic and can remain in place for a number of days. It can usually be taken out without causing your child much discomfort but sometimes they will need to be sedated.
- An electroencephalogram (EEG) detects and records electrical signals between nerve cells in the brain. It helps to assess brain activity and detect signs of seizures. An EEG can be done on the ward. Up to 20 leads are attached to your child’s scalp using a transparent sticky gel. The signals are transmitted to a computer that records them as waves on a sheet of paper. This test takes between 30 minutes and an hour.
Treatment
Ventilation
Medication
Removal of blood clots
External ventricular drainage (EVD)
After-effects of your child’s head injury
Rehabilitation
After your child leaves GOSH
Glossary
- Anticonvulsant – medicine used to control fits or seizures
- Burr hole – surgical hole made in the skull
- Cerebrospinal fluid (CSF) – fluid made naturally by the brain that circulates around the brain and the spinal cord
- Contrast – dye injected during a CT or an MRI scan
- Craniotomy – operation to open the skull in order to reach the brain
- Extra-ventricular drainage (EVD) – system used to measure the production of cerebrospinal fluid or relieve pressure within the brain by draining off fluid
- Hemiplegia – weakness of the face, arm and leg on one side of the body
- Hydrocephalus – an excess of cerebrospinal fluid inside the skull because of a blockage that stops it from flowing normally
- Intracranial pressure (ICP) – pressure within the skull
- Ventricle - small cavity within the brain that is filled with cerebrospinal fluid