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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Will The Squishy Area On Head Due To Hitting Be A Hematoma?

Hi, My son fell backwards today in his highchair. He hit the back of his head very hard. We had him examined, no CT done. He has been alert but does at times and holds his head. I noticed he has a 2.5 x 2.5 inch soft squishy area to his side of his head. The doctor did not find this upon assessment, it developed this evening. How do I know this is not a hematoma?
Mon, 25 Jul 2016
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Neurologist, Surgical 's  Response
Hello. Thanks for asking from HCM.


I can understand your concern. It is good that your son is conscious and oriented. As you have also visited doctor and he had ruled out signs of dangerous head injury like
:vomiting
: bleed through nose/ear/throat
: loss of consciousness more than 5 min or decreasing consciousness
: fits
: onset of new focal deficit
: non responding headache to painkillers
Due to absence of these signs, CT head was not done. But if you found any of above signs, even after few hours, consult ER as soon as possible. CT head might be needed to rule out fracture or brain bleed. Further management will be decided after CT report.

If no above signs at all, then no need to worry. You can manage swelling and headache at home
: Apply icepacks at injury site
: Give him painkiller like Diclofenac sodium after proper prescription

For soft area, first you have to observe it. If it is soft, tender, red to purple, on pressing fluctuations present , it might be hematoma. If firm, tender, red, temperature raised over it, no fluctuations, it is reactive swelling/inflammatory edema. It will disappear on its own in 10-14 days
: Avoid pressure at injury site.
: Keep your head at higher level than chest to relieve edema.

Hope it will help you. Take care. if still no relief, consult doctor.

Thanks.
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General & Family Physician Dr. Ralph Chambers's  Response
Hello

Yes, this is a hematoma--a collection of blood under the skin.
Nothing serious and it will be absorbed in time--no need to have it drained.
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Will The Squishy Area On Head Due To Hitting Be A Hematoma?

Hello. Thanks for asking from HCM. I can understand your concern. It is good that your son is conscious and oriented. As you have also visited doctor and he had ruled out signs of dangerous head injury like :vomiting : bleed through nose/ear/throat : loss of consciousness more than 5 min or decreasing consciousness : fits : onset of new focal deficit : non responding headache to painkillers Due to absence of these signs, CT head was not done. But if you found any of above signs, even after few hours, consult ER as soon as possible. CT head might be needed to rule out fracture or brain bleed. Further management will be decided after CT report. If no above signs at all, then no need to worry. You can manage swelling and headache at home : Apply icepacks at injury site : Give him painkiller like Diclofenac sodium after proper prescription For soft area, first you have to observe it. If it is soft, tender, red to purple, on pressing fluctuations present , it might be hematoma. If firm, tender, red, temperature raised over it, no fluctuations, it is reactive swelling/inflammatory edema. It will disappear on its own in 10-14 days : Avoid pressure at injury site. : Keep your head at higher level than chest to relieve edema. Hope it will help you. Take care. if still no relief, consult doctor. Thanks.