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Noticed bumps on head. Is there any risks?

DOCTOR OF THE MONTH - Nov 2013
Nov 2013
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Practicing since : 1994
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Dear Dr. XXXXXXX XXXXXXX

I asked about my son's head bump yesterday, and has been reassured. But, he has sustained two more since then. So, now 5 head bumps in a short period. Although you have reassured me yesterday, I still cannot help thinking whether there would be any cumulative effects. I will describe the five head bumps in the following.

The first one happened on Sunday afternoon 3pm, he was playing in a playground, stood up too fast and bumped the top of his head on a wooden frame. He cried hard for a few minutes and then back to play. About one hour later, he developed a fever 38.8 degree, checked by doctor who said he is fine, the fever is unlikely to be related with the head bump.

The second one is the one I have asked. It happened on Monday night 10pm. He was jumping in bed, fell back and bumped the back of his head on the metal rail. He was silent for a few seconds and then cried and threw up. He has been checked by doctor, he is fine, and you have reassured me that he has not sustained a concussion or any other XXXXXXX injury, the one-off vomiting is because of the crying.

The third one happened on Wednesday morning 10am. He was throwing a fit (because I took the chocolate away from him), and fell back, bumped the back of his head on the floor (wooden floor with rug on). He cried hard for a few minutes and then back to play.

The fourth one happened on Wednesday evening 7.30pm. He was pushed by his brother and bumped the side of head on the corner of a cardboard box. He cried a little bit and then back to play.

The fifth one happened this morning (Thursday) 9.00am. He fell from bed. Although his head not really reached the floor (I caught him), I am not sure whether he has bumped his head on the radiator. He cried a little bit and then back to play.

He has no swelling or lumps from all these head bumps, and he behaves normal after them. He is eating, sleeping, playing all as usual. But you know, the head bumps happened one after another, 5 head bumps in 3 days, I cannot help thinking about cumulative effects. Could you help me again to give your opinion on this point. Thank you so much.
Posted Sun, 2 Dec 2012 in Brain and Spine
 
 
Answered by Dr. Sudhir Kumar 2 hours later
Hi,

Thank you very much for getting back with more details. I appreciate your detailed description of all the five head bumps, and the resulting symptoms.

It is unfortunate that your son got five bumps to his head within a few days. However, none of the symptoms so far point to any XXXXXXX brain injury.

There are some good protective factors in a child's brain.

Firstly, the skull bone is soft, so, there is little risk of fracture of skull bone with injury.

Secondly, there is a good amount of plasticity in a child's brain. This means that there is a better chance of functional and nerve recovery even if there is some injury to brain nerves. This property is seen mostly before the age of eight.

So, as mentioned earlier, your son does not seem to have any ill effects of head injuries.

Please watch for repeated vomiting, lethargy, drowsiness, etc, which could be suggestive of XXXXXXX brain injury. If they are absent, there is no need to worry.

I hope it clarifies. Please get back if you have any further queries.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology) XXXXXXX Consultant Neurologist
Above answer was peer-reviewed by
 
Follow-up: Noticed bumps on head. Is there any risks? 36 minutes later
Dear doctor, thank you so much for the clarification. Yes, I should say he has no symptoms point to any brain injury, then can I assume that his brain has not been affected at all? You know, I always worry some effects not showing up until years later. And, five head bumps in a row, is it too much? Each of them may be fine, but when they happened so close, could there be any cumulative effects? Thank you.
 
 
Answered by Dr. Sudhir Kumar 7 minutes later
Hi,

Thank you for getting back.

I can understand your anxiety, however, I wish to reassure you that these would not lead to any ill effects later on in life. This is because there is no symptom of brain injury now. Moreover, even if there is mild brain damage now, the power of functional recovery in a 2-year old brain is 100%.

Also, there is no cumulative effect of multiple minor head injuries.

I hope it clarifies. Please get back if you have any more queries.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Above answer was peer-reviewed by
 
Follow-up: Noticed bumps on head. Is there any risks? 10 minutes later
Thank you doctor. Can I ask for your opinion, do you think there could be some mild brain damage in his case?
 
 
Answered by Dr. Sudhir Kumar 6 minutes later
Thank you for getting back.

The chances of any brain damage is very little, given that there are no symptoms to suggest that.

In a two-year old with brain damage, we would expect to see symptoms such as decrease in alertness, lethargy, fits, weakness of arms or legs, loss of speech, imbalance while walking, etc.

Since your son has none of them, it means there is no brain injury. In the worst case scenario, it could be a tiny focus of brain injury, which is clinically insignificant. In any case, there is no need to worry.

I hope it clarifies. Please get back if you have any further queries.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)

Above answer was peer-reviewed by
 
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