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Child got hit on the back of head after a fall, has large bump, pupils react to light, is not acting differently. Is he fine?

Hello, my 16 month old toddler fell off his rocking horse (about 2 feet off the ground) and hit the back of his head. He has a large bump, but he doesn t seem to be acting any differently. His pupils react to light, he has not vomitted, and he stopped crying about 5-10 minutes after his fall. This happened about 45 minutes ago. How long should we keep him to test he does not have a concussion and he is fine?
Asked On : Sun, 16 Sep 2012
Answers:  3 Views:  111
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Diseases and Conditions
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Emergency Medicine Specialist 's  Response
Dear Morrison, hello.
Concussion symptoms can develop within few hours to day. It can vary from persistent headache(continuous crying in case of toddler), irritability, confusion, seizures ,vomitting etc.
If he is fine and no other symptoms occur it is only external soft tissue injury. Bump occurs due to soft tissue injury due to the structure of the scalp.
Have a look at his state and plan accordingly.
Answered: Sun, 16 Sep 2012
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Pediatrician, Cardiology Dr. Pradeep Kumar's  Response
Thanks for the query
Scalp hematoma in a child less than 2 year old following fall needs a neuroimaging. If trauma is associated with loss of consciousness that is uncertain or very brief( few seconds only), irritability( now resolved), behavioral changes if any, scalp hematoma( particularly nonfrontal), the risk of clinically important traumatic brain injury is approximately 1 percent for a child with at least one of these criteria. Multiple or worsening symptoms or signs likely put the child at greater risk than an isolated finding. If immediate CT is deferred for these patients, we suggest observation for four to six hours to ensure no progression of clinical findings that warrant CT.
If you notice any of the above mentioned symptoms or vomiting even if it is delayed by several hpurs consult your doc as a neuroimaging will be needed in that condition.
Apply Thrombophob gel over the area this will help in reducing the size of swelling. A skull radiograph may be needed to rule out any fracture.
I hope this answers your query well
Wish you and your family good health
With regards
Answered: Sun, 16 Sep 2012
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General & Family Physician Dr. Kulbir Singh's  Response
Hello Morrison and thanks for the query
We have to note certain things like ENT bleed, vomiting or loss of conciseness, to confirm a head injury. If any one of these symptoms present than immediately rush to ER and rule out Head injury by CT scan. Further we have to observe the patient for about 24 hour from to time of injury. These symptoms may appear late so keep a check on that for next 24 hours.
But as the injury took place about 45 minutes ago and your child is OK since than, the chances of being injury are very less.
Hope you got your answer.
Best Wishes
Answered: Sun, 16 Sep 2012
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