When Is a Bump on the Head Serious?

Your skull does a great job of protecting your brain from injuries. Still, it seriously hurts when you get a “knock on your noggin.” To make matters worse, these accidents often result in an annoyingly big bump — or “goose egg” — that’s tender and painful for days.

The sight of this big bump can be alarming, especially when it happens to your child. Urgent care physician Allan Capin, MD, explains what to do when you or your child gets a bump on the head.

What is a goose egg on the head?

The medical term for a “goose egg” is a hematoma, which is another word for a bruise.

“A hematoma is bleeding and swelling under the skin,” explains Dr. Capin. “Your scalp and head are rich in blood vessels that can easily break from bangs and bumps. The blood gets trapped under your skin, creating a lump.”

People of all ages can get goose eggs, but it often seems to be kiddos who get that noticeable lump.

“Bumps to the head often affect toddlers learning to walk and active kids who bike or play sports,” he notes. “A big goose egg can be stressful for parents, but it doesn’t necessarily mean they have a serious head injury.”

What to do if your child bumps their head

It can be hard to know whether your kid’s goose egg is serious just by looking at it. Sometimes, a massive, angry-looking lump forms even if your child didn’t hit their head that hard. Don’t panic, but follow these guidelines to be safe:

Babies and toddlers: Get care

Children under age 2 should see a provider for any type of head injury. If you’re concerned it could be serious, take them to the nearest emergency room.

“A young child’s skull is still soft, so they have a higher risk of a brain injury,” states Dr. Capin. “They also can’t tell you how they’re feeling, so it’s harder to evaluate their symptoms. With this age group, always play it safe and seek medical care.”

Kids age 3 and up: Check the location and watch for symptoms

It’s also not always easy to know what to do when a preschool- or school-aged child bumps their head. In these cases, consider where they hit their head — and how hard.

“Forehead injuries are common in kids, and this area of the skull is pretty tough,” says Dr. Capin. “Although the goose egg looks terrible at first, they generally recover quickly. Small bumps to the forehead are usually not serious.”

Other areas of the head — like the temples, behind the ears and the face — are more fragile than the forehead.

“A hit to the face, side or back of the head usually requires a check from a healthcare professional,” he adds. “We want to make sure they don’t have a broken bone in their skull or a concussion.”

Bottom line? You know your child best. If they get a goose egg, watch their behavior. “If after careful observation, they are acting consistently well and they’re alert and responding to you, chances are the injury may be minor,” he says.

How to treat a goose egg in an adult

Adults may not get goose eggs as often as little ones, but that doesn’t mean you should brush them off. Head injuries can be serious at any age.

Older adults in particular have a high rate of bumps to the head from falls because of:

• Chronic conditions like Alzheimer’s disease or diabetes.
• Declining coordination and muscle tone.
• Medications that can cause tiredness or dizziness as side effects.

Even without health conditions or medications, older age can make a brain injury more likely.

“Our brain naturally shrinks a little with age, so there’s more room in the skull,” Dr. Capin explains. “This little area of extra space makes it easier for your brain to hit the inside of your skull during a fall or accident.”

And if you’re on blood thinners, there’s an additional risk of severe bleeding.

“A slow bleed in the head is dangerous, but you can’t see it without specialized imaging such as a CT scan,” he adds. “Older adults who take blood thinners should always seek medical care if they happen to hit their head.”

When is a head injury serious?

Some head injuries require emergency medical care. If your child hits their head, head to the ER if you notice:

• Blood or watery fluid coming out of their nose or ears.
• Dizziness.
• Excessive sleepiness or inability to wake them up.
• Fussiness or irritability.
• Nausea or vomiting.
• Pupils that are different sizes.
• Stumbling or trouble walking.
• Swelling or bruising around their face, behind their ears or under their eyes.

Signs of a serious head injury in adolescents and adults include:

• Abnormal behavior.
• Blurred vision.
• Headache that gets worse or doesn’t go away.
• Tinnitus (ringing in the ears).
• Slurred speech.
• Trouble concentrating.
• Weakness on one side of the body.

How to shrink a goose egg

Even a minor goose egg can be a real pain. If you want to minimize the bump, act fast.

“An ice pack can encourage the bleeding to stop, which will shrink the bump,” shares Dr. Capin. If you can get your hands on an ice pack, use it as soon as possible after the injury:

• Cover the ice pack with a cloth to protect the skin.
• Gently press the ice pack on the bump for up to 20 minutes.
• Take a 30-minute break, and reapply if needed.

Preventing goose eggs

Accidents happen, but you can help limit head bumps and injuries in children if you:

• Closely supervise infants and toddlers.
• Install wall safety straps for shelves and other furniture that could tip over.
• Require helmets for biking, skating and riding toys.
• Use a properly fitted car seat for babies, toddlers and young children.

Adults can help prevent head injuries with these fall-prevention strategies:

• Keep electrical cords away from areas where people may walk.
• Know the side effects of medications you take.
• Remove throw rugs and area rugs, which can be trip hazards.
• See your provider regularly to discuss any chronic conditions and your fall risk.
• Use motion-activated lights throughout your home so you don’t have to walk in the dark.

Knowledge is power

Our brains are precious cargo, so a bang on the head can send your stress levels to the ceiling. Knowing the signs of a brain injury can help you gain some control over the situation.

“When a bump to the head happens, try to assess the symptoms,” advises Dr. Capin. “Look for signs of possible bleeding or a brain injury — persistent headaches, nausea, vomiting, blurry vision, etc. — and don’t hesitate to contact your provider or go to the ER if you’re unsure. Even if it turns out to be minor, you can have peace of mind knowing you got it checked out.”