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Child developed hematoma post hitting the head, no vomiting, loss of consciousness or headache, behaving normally. Treatment required?

My four-year-old fell from a pool slide ladder and hit her head on concrete today. She developed a hematoma almost immediately (~6cm by 4cm) on the left-front side of her forehead . It s now eight hours later. The swelling has been reduced a bit and seems to be spreading slowly outward from the site. It is fairly soft to the touch, especially in the center. She never lost consciousness , did not vomit , has not complained of persistent pain or headaches, has not seemed to be compromised in terms of balance, and has exhibited no behavioral or personality changes. She has been asleep for about an hour (I ve checked a few times to make sure her breathing seems normal and that the hematoma hasn t altered physically in any drastic way). Assuming all goes well this evening, would you recommend that I have her pediatrician examine her tomorrow? She hasn t exhibited any of the classic signs of internal bleeding, but I don t want to take any chances with a head trauma. Thanks.
Asked On : Thu, 19 Jul 2012
Answers:  2 Views:  205
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Pediatrician 's  Response
Dear parent,
For any head injury first 24 hours r very important. So Incase of any symptoms of internal bleeding like persistent vomiting, headache, fits or unconsciousness u should rush to the hospital. As if now only observation is needed. And the hematoma will gradually resolve.
Answered: Thu, 19 Jul 2012
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Pathologist and Microbiologist Dr. Anju Choudhary's  Response
Hi dhull, your history is very precise and complete, thank you. As you rightly feel its not good to take chances with head trauma and it would be good practice to take her to the pediatrician at the earliest available opportunity. History suggests that its just a hematoma but do get an x ray done and if required a CT scan. Take care.
Answered: Thu, 19 Jul 2012
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