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Infant having a lump on the head after a fall. No vomiting. Need to go to emergency?

My 7 month old son fell from an ottoman and hit his head on the table. There s a decent sized bump with a line through it and the bump is turning a little purple but it s mostly red. He cried off and on for a while. No vomit and I can t tell if he s out of it because he was tired before this happened. This happened 30 minutes ago. His pupils dilate like normal. Should I take him into the er? Thanks.
Asked On : Tue, 25 Sep 2012
Answers:  1 Views:  111
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Pediatrician, Cardiology '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 there is vomiting even if delayed for several hours this also warrants neuroimaging.
Apply Thrombophob gel over the area this will help in reducing the size of swelling. In children below 2 yr of age a skull radiograph may be needed to rule out any fracture. Better you consult your doc for clinical assessment and to assess the need of neuroinaging or Xray.
I hope this answers your query well
Wish you and your family good health
With regards
Answered: Wed, 26 Sep 2012
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