The vast majority of head injuries in children areminor. They fall, hit their head on the floor or wall or coffee table butkeep on running. Generally you are in good shape if this is thescenario.  If there is a laceration (or a cut) of the skin, definitelyhave your child checked out.  They may need stitches. Of course, theywill need to be evaluated for fractures under those lacerations.  This mayinvolve possibly getting an x ray. Sometimes it is possible to tell byexamining the actual cut and not have to expose the child to the radiation ofan x ray.  There is usually not a very high exposure to radiation withmost x rays, but it is something to consider. 

There is an old wives tale which goes something likethis: if there is a bruise, they are fine.  If no bump comes up on theskin, then that can be bad....so don't let them go to sleep, whatever youdo. Yes, this is an old wives tale. There may be no injury visible orthere can be a large bruise on the head. They can have severe internalinjury whether there is a bruise on the skin or not. You really need toconsider how your child is acting. They can act stunned or bewilderedright after their injury and then be fine. That is also a good sign thatthey are alright. They may vomit once or twice. That, too, isconsidered a normal occurrence after bumping your head. More than threetimes warrants an evaluation. If your child does fall asleep, do notpanic. Stir your child to see if they awaken easily. If they do notawaken easily, call your doctor.

If your child loses consciousness or can't remember things,especially around the time of the injury, have them seen immediately. Ifthey act like they don't recognize you, have a seizure, don't respondappropriately or if there are any signs that you feel are "just notright" for your child, do not hesitate to call your doctor or bring themto the nearest Emergency Department. If they fall asleep and you cannot wakethem up, call 911 and have your child transported by ambulance. Childrenwho have a loss of consciousness or amnesia to the event (don't remember whathappened) and don't remember events earlier in the day generally need a CTscan.  These do expose your child to a bit more radiation, but it willgive the doctor very important guidance in caring for your child.  Ifthere is any abnormality, your child will need to be seen by a specialistcalled a neurosurgeon.  If there is no abnormality and your child is doingwell, it will be the peace of mind you were hoping for.

Onefinal tip. When a child has a head injury, acetaminophen is generallyrecommended over ibuprofen. Theoretically ibuprofen can create more bleedinginternally. Acetaminophen will not and is safer in thissituation. Now about those bumpers you were going to put all over yourhouse.....