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Child got hit on the head, has bruise near the eye with swelling, given tylenol, checked pupils. Any other symptoms I need to be alert for?

My 3 1/2 year old son was asleep and fell off my couch and hit his head on the corner of our coffee table. Now he has a bruise near his left eye and it has swollen up. I put an ice pack on it, and gave him some infant tylenol for pain. I checked his pupils and kept him up for 30 minutes before he fell asleep again. Is there anything else I should keep a watch for? Any other symptoms I need to be alert for? The swelling looks horrible. It is about the size of a large marble, purple with 3 small scratches. Now I m afraid to go to sleep because I want to keep checking on my son. I just don t know what else I should be looking for.
Asked On : Thu, 20 Sep 2012
Answers:  2 Views:  129
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Pediatrician, Neonatology 's  Response
Iam sorry about your child. A hematoma near the eye is in a small child is not a pleasant sight.
You observe for any blood within the eye- subconjunctival hemorrhage which if present also resolves by itself.
Look for any sign of vomiting, nausea which is also unlikely as he did not fall on his head.
The swelling takes 3-4 days to subside completely.
get a doctors opinion when possible.
Answered: Thu, 20 Sep 2012
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Pediatrician Dr. Nasir Mohammed's  Response
Hello there,
A head injury is certainly a cause of concern and alarm and in your case the injury is quite large. As you rightly checked the pupils, attention should be paid to his state of consciousness. Even during sleep, you can ascertain if he can be aroused without difficulty or not. If he wakes up, and looks otherwise fine and alert, you need not worry. Since it requires a certain degree of vigilance, it is best to admit your baby in a nearby hospital for at least 24 to 48 hours. As per the advice of the attending doctor, a CT of the head can be planned to completely allay your anxiety and ensure there is no internal injury.
Take care.
Answered: Thu, 20 Sep 2012
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