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John Atkinson, M.D.close window
John Atkinson, M.D.
Bump on the head: When is it a serious head injury?
Recently, my daughter got kicked in the head during a soccer game. She seemed fine at the time but later developed a sizable lump on her forehead. Is this a concern?
from John Atkinson, M.D.
Probably not. Head trauma resulting from play or sporting events is a common concern for parents, but few bumps on the head of this nature result in serious injury.
The forehead and scalp have an abundant blood supply and injury to these areas often results in bleeding under the skin. When the bleeding is restricted to one area, it causes bruising and swelling. Doctors refer to this as a hematoma.
Keep in mind that even a minor head bump can cause a large swelling. And the mechanism of injury — speed, momentum and size of the people (full-grown adolescents versus children), and the forces involved (such as a concrete floor or other hard surface) — may increase the possibility of serious injury.
When to see a doctor
Occasionally, a blow to the head may be severe enough to cause bleeding in or around the brain. This type of bleeding can cause an intracranial hematoma, a serious condition that puts pressure on the brain.
See a doctor within one to two days of a head injury, even if emergency care isn't required.
Seek emergency medical attention if your child experiences:
- Unconsciousness, confusion or disorientation immediately after a head injury or after some time has passed
Also seek emergency attention if your child exhibits the following signs or symptoms following a head injury:
- Persistent or worsening headache
- Memory loss
- Mood changes
- Cantu C, et al. Head injuries. In: DeLee JC, et al. DeLee & Drez's Orthopaedic Sports Medicine: Principles and Practice. 3rd ed. Philadelphia, Pa.: Saunders Elsevier; 2010. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-1-4160-3143-7..10015-6&isbn=978-1-4160-3143-7&type=bookPage§ionEid=4-u1.0-B978-1-4160-3143-7..10015-6&uniqId=238887570-3#4-u1.0-B978-1-4160-3143-7..10015-6. Accessed April 8, 2011.
- Ahn ES, et al. Intracranial epidural hematoma in children: Clinical features, evaluation and management. http://www.uptodate.com/home/index.html. Accessed March 31, 2011.
- Schutzman S. Minor head injury in infants and children. http://www.uptodate.com/home/index.html. Accessed March 31, 2011.
- Mami AG, et al. Management of mild head injury in the pediatric patient. Advances in Pediatrics. 2008;55:385.
- Concussion. Centers for Disease Control and Prevention. http://www.cdc.gov/concussion/signs_symptoms.html. Accessed March 4, 2011.
- Concussion in sports. Centers for Disease Control and Prevention. http://www.cdc.gov/concussion/sports/recognize.html. Accessed March 4, 2011.
- Atkinson JLD (expert opinion). Mayo Clinic, Rochester, Minn. April 15, 2011.