Blows to the head are quite common in contact sports like football, rugby, soccer, hockey and cricket,
and often result in mild forms of concussion (temporary disorientation with or without temporary unconsciousness).
This is because the human skull is engineered in such a way that it is able to absorb the shock of a mild blow quite effectively.
Most of the shock is absorbed at the seams where the bones of the skull are knit together. This process is only completed by the age of five,
and a small child’s skull and brain is therefore much more prone to serious injury. The large dome-shaped portion of the skull, the cranium,
acts as a shield to the underlying brain that is wrapped in three bag-like layers of protective tissue and floats in a sea of cerebrospinal
fluid that also serves as a shock absorber. However, despite all these precautions the brain is not invulnerable to injury and coaches and parents
should be able to differentiate between mild concussion, after a blow to the head, and/or a fractured skull.
Concussion or a fracture?
When the skull receives a blow, the impact spreads through the arching bones of the skull and every time the shock waves pass across one of the borders or sutures where the skull’s bones meet, a little of the wave’s force is dampened and absorbed. The force of a soft blow will soon be dissipated but if the blow is beyond the limit of the elasticity of the bones, a fracture will occur.
Any head injury incurred during sport may either cause concussion or fracture the skull. The chief dangers associated with fractures include the possibility of pressure on the brain and internal bleeding. And any pressure on the brain, either from fluid or blood leaked into and around the brain or a swelling of the brain tissue, can cause the more serious condition of compression, which may lead to coma and may only become evident up to 48 hours after the incident.
Signs and symptoms
The presence of any of the following signs and symptoms demand extra caution and immediate medical attention:
- Blood and clear fluid running from the mouth, nose or ears
- Bleeding from the mouth
- Unequal pupil sizes
- Speech or vision disturbances
- Loss of memory
- Convulsions
- Weakness or paralysis on one side of the body
- Muscle twitches
- Altered pulse rate (more than 80 or less than 60 beats per minute)
- Unusual pallor of the face or a high temperature and flushed face
- Vomiting
- Severe headache
- Failing alertness and level of consciousness
Fortunately, children are very resilient and usually recover pretty quickly from a blow to the head and mild concussion.
However, it is vital never to ignore any of the abovementioned symptoms. Also, try to dissuade both young and older children
from engaging in activities that involve blows to the head and/or insist on them wearing protective helmets.