infant fall with head swelling 3 days later

[tina1024]

My daughter fell down about 13 carpeted stairs 3 nights ago.  She is 13 months old, and seems to be fine.  I called the nurse at the pediatricians office and she advised me to monitor her for 24 hrs, and if she acted normal, she did not need to be seen.  She has acted normal and nothing seems to be broken, but I just noticed some swelling on the right side of her head  It is not her forehead area or the side...more just right of midline towards the front of her head.  It feels soft also, but doesn't seem to be discolored at all.  Is this a just a bruise, or a fluid collection?  I am very concerned.  Should I take her to the Dr. even though she is acting fine?  

[tina1024]

Hello again.  Just an update on my little one.  She still has some swelling over the fracture  site which is on the right parietal region...dr. says it is a hematoma.  She did not get a CT scan as Dr. felt that it was unlikely that she has any bleeding in the brain since she has been acting perfectly normal since the injury.  The hematoma seemed to have gotten a little softer then firmer but about the same size at last check up last week.  Dr. says it could take up to a year for the hematoma to heal completely?  She also mentioned that upon the results of a second xray to be taken in April, if the fracture is not healed, there would be a possibility of an encephalocele? Wouldn't there be any external signs; ie. behavior, restlessness, etc. if that was the case?  How could there be a part of the brain protruding out of the fracture site, and there not be any signs?  Should I really be worrying about that possibility at this point? Thanks for responding.

[Bhupinder Kaur, MD]

Hello,

I think that if there is a confirmed fracture on x-ray then definitely an MRI head or even a CT head would be the next step to rule out any damage to the soft tissues or the surrounding areas of the fracture site. Treatment will depend on the damage and the type of fracture your child has. Most skull fractures heal within 3 to 6 months. The younger the child is, the faster the fracture will heal without further problems. Your child may also need antibiotics and anti inflammatory pain killers.So medical intervention is required.

I suggest that you should consult a pediatric neurologist if your child shows any odd behavior,unconsciousness,seizures etc.

Hope it helps.Take care and pls do keep me posted on how your daughter is doin

[tina1024]

Thank you for responding.  I did take her to the MD this morning who suggested she get a skull series.  After the x rays it appears that she does have a skull fracture.  Radiologist does not feel CT is necessary unless my daughter shows any abnormal behavior.  What do you think?

[Bhupinder Kaur, MD]

Hello,

The bump which has formed on the head of your daughter seems like a small hematoma. The head and scalp in children have abundant blood supply.So in case of injury,there is bleeding under the skin.When it becomes localized to one area,it causes a swelling and is called a hematoma.

Usually the hematoma goes away in a few days,skin discoloration may take one to two weeks for healing.Apply ice in a towel or cold compresses to the swelling and look out for any vomiting,headache,seizures or unconsciousness.If present,then it is a cause of concern and should be evaluated by a pediatrician.

Hope it helps.Take care and pls do keep me posted on how she is doing.

[momof3under6]

I would call the md or take her in.  With children, things tend to be fine for a while and then eveything snowballs.  It could be nothing BUT do you really want to risk it?