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7 year old, head injury, concussion, bleeding, head pain on playing sports, swelling near cut. Brain injury a possibility?

4 days ago, my 7 year old son hit is head and was taken to the emergency room for stitches. He was scootering (without a helmet) and “fell asleep” while on his scooter, slamming into a cement wall. He had been telling his father he was tired (rightfully so, they had scootered about 3 miles and had woken early after a long night at his school’s fundraiser to 2 hours of martial arts training) his father thought he meant his legs were tired and told him to keep going and to catch up with him, moments later he heard “Daddy” turned around and saw our son standing there, as the scooter fell to the ground, blood running down his face from his forehead (his right side.) He then said “Daddy what happened?” His father replied “I don’t know. What happened? You tell me.” Our son then said he thought he had closed his eyes for just a second, because he was so tired. He carried him home, cleaned off the wound and we decided that even though it was only 3/4 of an inch to an inch long, since it was deep and on his face we should take him to the ER. We did, it was busy and our son was scared, so by the time we were seen he said he had no headache (his head hurt where the cut was.) They asked if he had ever passed out or fainted before, we said no. They asked if he had lost consciousness , we said we thought he had not, but rather that he had nodded off and been woken up by the impact. They stitched his head. Soon after we left the ER he said he felt funny, dizzy and his tummy hurt. From the long day in the ER we had missed lunch and assumed the upset tummy was from not eating and the local anesthesia . He ate and was incredibly tired, we went home soon after and he went to bed, I slept in his room with him and woke him every few hours. He didn’t like discussing the accident and didn’t want to see the stitiches. He left school the next day because we didn’t have a proper doctor’s note. I decided to keep him home until we could get an appointment rather than wait in the ER again or even have him spend the next few days unable to participate in recesses, PE, or any activities, he would have also had to sit in the office during lunch and snack (school district policy with stitches.) This to explain he had very light activity for 2 days. Yesterday we went to doctor, our dr. said my son most likely had not fallen asleep but rather had suffered a slight concussion and lost the moment of impact and directly before and after. He took out the stitches , said it’s better to remove early for facial stitches to avoid scarring. He did explain to us that my son should not have any rough play or swimming for the next week to 10 days to avoid opening the wound back up. There seemed to be no swelling or infection. My son is very stoic and did not complain of any pain when stitches removed until we left and then said it hurt a bit like a shot when the doctor had cut the first 2 stitches. He returned to school today, participated in recesses and PE, which entailed many head down excersizes, bear crawl, burpees, plank etc. in warm 85 degree weather. when we arrived home he was a little off, hard to explain, just off, moody, he began to play, running around, playing on his bunk beds etc. We’d been home about 20 minutes when he became very emotional, finally telling me his head hurt really bad. I checked his wound, it was still “clean” looking but the skin around it was swollen, not red like infection but swollen for 1/2 inch to 1 inch circumference. He agreed to take ibuprophen, he NEVER wants to take medicine, and went to his bedroom himself, crawled into bed and began crying softly. He told me his head hurt when he runs, or jumps or walks more than 3 steps and that it wouldn’t go away. He stayed in his room, lying in bed (my son never does this) until dinner. We ate dinner, he ate very little, but did drink. He got up from the table and went to the sofa, a few minutes later he stated he was sad, and explained it was awful, he had tried to play but his head hurt too bad when he again, run, jumped or walked more than three steps fast. I have since kept him quiet, resting but I’m concerned there was brain injury the doctors were not aware of (because my son was so well behaved and reserved in front of the doctors, I think his fear may have kept him from being completely honest about the pain.) Is it likely that the headaches just started days after an injury? Should we ask for a test that could expose a concussion etc.? I’m nervous that there is an unknown head injury.
Asked On : Sun, 13 May 2012
Answers:  1 Views:  123
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Neurologist 's  Response
Nov 2013

Thank you for posting your query. I must appreciate the detailed description that you provided regarding your son's medical condition. It makes it easy for us doctors!

Most likely, there is no serious internal injury to brain, as your son does not have any significant symptoms to suggest that (severe headache, recurrent vomiting, double vision, fits, weakness of one arm or leg, etc).

However, he deserves a CT scan of the head, as his symptoms are persisting. This is mainly to excldue any remote possibility of internal brain injury.

Best wishes,
Dr Sudhir Kumar MD DM (Neurology)
Senior Consultant Neurologist
Apollo Hospitals, Hyderabad
Answered: Thu, 25 Oct 2012
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