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Sweating, vomiting after head injury. Should I worry?

Resolved Question:

Hi,

My son is having 5 years. When he is playing in front of home, a motor bike hit on his head, little upside of eye. He went to unconscious for few seconds and woke up once moved him.

After 3 or 4 hours, he was getting vomiting for 4 times. He got sweating for 10 minutes then after he is ok.

We took doctor appointment and met. She suggested to take CT scan of brain and Eye check up.

We took the CT scan of brain and got report with no injuries. He got swelling on top of left eye and below eye brows.

Now is talking with us and eating food. This is happened yesterday morning. 36 hours completed after this.

But we worrying about he went unconscious for some time and got vomiting 4 times. So want to know the reason why he got vomiting and unconscious and what are risks he may face in future.

or Should we re check the head injury again?

Regards,
Sreeni


Category: Pediatric Neurologist

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Category: Pediatric Neurologist
Dr. Sudhir Kumar is online now

Expert:  Dr. Sudhir Kumar replied 4 Days.

Dear Parent,
Thank you for your query at DoctorSpring.com
I can understand your concerns. That does sound scary.
Head injuries are one of the most important as well as dangerous problems in children. I am glad that Master Madhusudhan does not have anything serious.
Let me clarify a few concepts:
Head trauma causes various forms of injuries to the brain. It can be bleeding inside or outside the brain (extradural, intramural, sub-arachnoid, intra-ventricular, intra-parenchymal hemorrhage, etc). These names are basically to identify the site of bleeding within the brain and its covering layers. This is one of the most dangerous forms of head injury ad these can be picked up easily on a CT scan. These are the group of patients who go on to require a surgical evacuation of the bleed. So your son does not have any of these. THAT IS DEFINITELY A GOOD THING.
The other major form of injury is called DIFFUSE AXONAL INJURY. The nerves inside the brain are similar to long, thin strings (simple analogy for improving your understanding). However these thin strings are in billions and are too small to be seen with a naked eye or even a CT scan. Due to the force of the impact there is shear force and stretching of these neurons. This leads to injury and swelling of their axons (string portion of neurons). THIS INJURY CANNOT BE PICKED UP BY A CT SCAN. In fact even MRI may not be able to quantify the degree of diffuse axonal injury. This can present with loss of consciousness during the acute phase and vomiting subsequently. Your child seems to have had this form of an injury.
The good thing regarding DAI is that - It does not require any surgical intervention or specific drugs.
The bad part, however is that - When it is severe, it can cause swelling of the whole brain and disastrous rise in intracranial pressure and even death. However, your child does not seem to have such severe form.
So, at this point, I would advise the following:
Ensure adequate bed rest. Watch for any headache or vomiting that may suggest the onset of a raised intracranial pressure or brain swelling, Ensure adequate fluids intake.
The long term effects of such an injury are unlikely to be significant. However, there are reports of mild cognitive an language dysfunction in children with mild-moderate head injury after five years. But, in Madhu's case, we do not anticipate any such complications, if he continues to remain OK for the nest 48-72 hours.
Hope this was helpful,
Regards.


Patient replied :

Thank you for quick and detailed response.
I'm very happy to hear that Madhu does not have any problem. As of now he doesn't have any pain around the head. Anyway we will monitor him for next 48 hours and let you know.
Best regards, Sreenivas


Expert:  Dr. Sudhir Kumar replied 3 Days.

Hello,
Thanks a lot and that's really good.
You can follow-up as you want.
Regards.


Dr. Sudhir Kumar
Category: Pediatric Neurologist
Experience: 
Senior Residency, Fellowship: DM, Neurology, CMC, Vellore, 2001
Junior Residency: MD, Internal Medicine, CMC, Vellore, 1998
Medical School: MBBS, Christian Medical College, Vellore, 1995
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