Child Head Injury: Symptoms & When to Worry | Kids Clinic Singapore


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(Last updated: 17 Jul)

Preventing Head Injuries in Children – Tips For Caregivers

Nothing can replace close adult caregiver supervision in childhood injury prevention. Children are not able to identify the potential injury hazards in their environment and they need your care and protection.

Preventing Injuries in Infants and Toddlers:

  • Do not leave your baby unattended, even for a few seconds, on an adult bed or baby cot without proper barriers.
  • Do not use the sarong cradle. Head injuries, skull fractures and even deaths have occurred when infants fall off the sarong or when the springs or attachments of the cradle breaks.
  • Do not use a baby walker. They can topple over and many falls causing head injuries have been documented locally and overseas. Some cases of deaths as a result of these injuries have been reported.
  • Do not shake your child violently even when you may feel frustrated or angry. This can cause severe and fatal internal head bleeding.
  •  Ensure that the high chair your child uses is of a sturdy design and use the appropriate restraints when your child is seated in it.
  • Use an age-appropriate car seat for your child.

Preventing Injuries in School-going Children:

  • Supervise children closely in playgrounds. Prevent them from climbing onto unstable and high structures. Avoid playgrounds that are poorly maintained or have unsafe designs (e.g. hard flooring, rusted or broken metal parts).
  • Ensure that a properly fitted protective helmet is used for activities like cycling, skating, skateboarding, roller blading, or during the use of the skate scooter.
  • Teach your child road safety habits. Do not allow your child to play or go on the roads unsupervised.
  • Ensure that your child puts on age-appropriate seat belts or booster seat restraints while in a vehicle.
  • Teach your child sports and recreational safety rules.

Does My Child Need a Skull X-ray if He Hit His Head?

Skull X-rays help to identify skull fractures. However, they do not directly show brain injury or bleeding within the skull. A skull X-ray is not a reliable indicator of bleeding within the skull or brain injury. Your doctor will examine your child and decide if a skull X-Ray is really necessary.
Skull X-rays are seldom necessary. Clinically abnormal signs and symptoms as mentioned above are much more reliable than skull X-rays as predictors of injury or bleeding within the skull. A normal skull X-ray does not rule not bleeding within the skull or brain injury. Close monitoring of the child’s behaviour over the next 72 hours of head injury is still necessary even though the skull X-ray may be normal. If brain injury or bleeding within the skull is suspected, the child will need urgent CT scan.

Head Injuries in Children – When to Worry?

If the child has had a head injury, parents and caregivers need to look out for the following at home. Bring the child immediately to the emergency department if any of the following signs and symptoms appear within the first 72 hours after discharge:
  • Any unusual behaviour not considered normal for your child
  • Confusion about familiar names and places
  • Worsening or persistent headache
  • Seizures (“Fits”)
  • Unsteady gait (not able to walk normally or steadily)
  • Unusual drowsiness (feeling sleepy all the time)
  • Inability to wake your child from sleep
  • Persistent Vomiting
  • Double or blurred vision
  • Bleeding or watery discharge from the ear or nose
A doctor performs a checkup towards a child with injuries on his forehead
If your child has fallen and hit his head, monitor him closely for further symptoms.
Avoid giving your child any medication that may cause drowsiness (or sleepiness) unless instructed by your doctor.
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Incorporated in 2005, Singapore Medical Group (SMG) is a healthcare organisation with a network of private specialist providers across four established pillars - Aesthetics, Diagnostic Imaging & Screening, Oncology and Women's & Children's Health. Within Singapore, SMG has more than 40 clinics strategically located in central Singapore and heartland estates. Beyond Singapore, SMG also has an established presence in Indonesia, Vietnam and Australia. Learn about our privacy policy here.

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