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Child complaints of headache followed by fall with fixed eyes and unconsciousness for several minutes

DOCTOR OF THE MONTH - Feb 2013
Feb 2013
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Answered by

Pediatrician
Practicing since : 2002
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Question
My son was waiting in cafeteria line in a hospital. He complained of headache and fell backwards like a board, I could not break his fall:( and bounced with his head twice on tile floor:( his eyes were fixed downwards and was unconscious for several minutes, at that point, Code blue was called by the hospital staff and he was lifted and rolled to the ER where he came too.. My question is this, they sent us home to follow up with pediatrician, but he had no mri or cat scan:( today he is saying he feels drunk and woozy is this normal? he had no blood work at hospital, but he had bloodwork today, his heart ecg showed a RBB, is this normal? should I be concerned? or what should I watch for?
Posted Mon, 28 Oct 2013 in Child Health
 
 
Answered by Dr. E Venkata Ramana 28 minutes later
Brief Answer:
Needs immediate evaluation by pediatrician

Detailed Answer:
Hi,

Thank you for your query on Healthcare Magic.

I went through your description of the child complaints of headache followed by fall with fixed eyes and unconsciousness for several minutes.

This type of presentation is seen in the following conditions:

1.Seizure episode.

2.Syncope like vasovagal

3.Heart rhythm abnormalities

He needs investigations like CT Scan brain, EEG, 2D Echo after clinical examination by his pediatrician to look for the above problems.

ECG showing right bundle branch block (RBB) is an abnormal finding suggestive of heart rhythm abnormality and this finding has to be correlated by pediatrician and further opinion has to be taken from pediatric cardiologist.

And as he fell down on ground with this episode, he needs evaluation to rule out XXXXXXX injury to brain with clinical examination and imaging study such as CT Scan brain.

Feeling drunk and woozy are abnormal and concerning symptoms and needs immediate evaluation by his pediatrician.

Support the child while standing and walking to prevent further falls because of his symptoms of drunk and woozy.

And I suggest you to consult the pediatrician immediately for examination and for further investigations.

Hope I have answered your query, if you have any clarification please let me know.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Child complaints of headache followed by fall with fixed eyes and unconsciousness for several minutes 5 minutes later
we see pediatrician again tomorrow should we demand a CT scan tomorrow? or should we take him now?
my son is sleeping now should I wake him up everyhour? or could wait for morning?

 
 
Answered by Dr. E Venkata Ramana 43 minutes later
Brief Answer:
Pediatricin will assess for the need of CT scan.

Detailed Answer:
Hi,

Thank you for getting back.

As the child is sleeping now, no need to wake him up every hour.

But I suggest you to observe him for any concerning symptoms like abnormal movements of limbs, seizure like activity, or incoherent behavior and if you observe any of these findings, consult emergency immediately.

And in the morning consult his pediatrician as early as possible for clinical examination and discuss your concerns. And the doctor will order for appropriate investigations depending on the review of child complaints and clinical examination findings.

Hope I have answered your query, if you have any clarification please let me know.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Child complaints of headache followed by fall with fixed eyes and unconsciousness for several minutes 5 minutes later
ok thanks..we are to see doctor tomorrow again 10am..Thank you again:)
 
 
Answered by Dr. E Venkata Ramana 4 minutes later
Brief Answer:
You are welcome.

Detailed Answer:
Hi,

Thank you for getting back. If you have any clarification please revert back to me and if you don't have any doubt I request you to close the discussion and rate my answer.

And I wish your child good health.

Best regards.
Above answer was peer-reviewed by
 
Follow-up: Child complaints of headache followed by fall with fixed eyes and unconsciousness for several minutes 8 minutes later
How do I know if he is getting worse?

We wanted CT scan in Emerg but they said that's too much radiation.

and today he had lots of bloodwork, now he is having pain down his wrist..is this mnormal? or you think his nerve got damaged?
what can I do to help him with pain?
 
 
Answered by Dr. E Venkata Ramana 11 minutes later
Brief Answer:
Observation. Give Tylenol for pain relief.

Detailed Answer:
Hi,

Thank you for getting back.

Closely watch the child sensorium, level of consciousness, activity, speech, behavior, and his coherence when he wakes up.

Watch for abnormal findings like severe headache, vomitings, abnormal and incoherent behavior and speech, seizures, paucity of limb movements and if you detect any abnormality, report to emergency immediately.

CT scan is associated with radiation effects and its need will be decided by the doctor depending on the child complaints if he feels its neccessity outweighs the risk of radiation.

There will be pain from where the blood is removed for blood work. Nothing to worry as this pain will subside.

Removing blood from vein doesn't lead to nerve damage. For pain relief, you can give Tylenol (paracetamol) in prescribed dose.

Hope I have answered your query, if you have any clarification please let me know.

Regards.
Above answer was peer-reviewed by
 
Follow-up: Child complaints of headache followed by fall with fixed eyes and unconsciousness for several minutes 2 minutes later
ok Thanks so much:)
 
 
Answered by Dr. E Venkata Ramana 0 minute later
Brief Answer:
Welcome.

Detailed Answer:
Hi,

You are welcome.

Best regards.
Above answer was peer-reviewed by
 
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