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The very young are also prone to head injuries, as their heads are larger in proportion to the rest of their bodies. “Like a poppy on a stalk, the head of a young child is relatively heavier, and his brain stem and upper cervical spine can be easily traumatised,” ​Associate Professor Ng Wai Hoe, Medical Director, National Neuroscience Institute​ (NNI) and Academic Chair, SingHealth Duke-NUS Neuroscience ACP said.​​​​

This is why Shaken Baby Syndrome – in which an infant gets a devastating brain injury from being shaken violently – is so serious. “Many either die or are condemned to a vegetative state.”

The one ray of hope is that a child with a serious head injury can recover faster than an adult.“This is known medically as neuroplasticity. The brain is still ‘plastic’ and has a remarkable ability to recover.” This means that in a two-year old whose speech is affected by a head injury, another part of the brain can take over because his speech centres have not fully developed. And an infant’s fontanelle – the soft spot on top of the head – allows for brain swelling.

Where head injury is concerned, the mantra is really “protect and prevent”.

Protection is key

Prof Ng advised those who engage in sports during which head injuries may occur, such as cycling or in-line skating, to wear helmets. “It’s not foolproof. I have seen motorcyclists with smashed helmets and injured brains. But helmets can reduce the impact and absorb a significant amount of shock.”

He also advised those in vehicles to wear safety belts, a​nd if possible to shield their heads with their arms or bodies when an impact is imminent. He said that this is crucial, and it is why someone may die from a fall at home while another walks away from a bike crash.

“If you mitigate impact by, say, breaking a fall with your arm, the injury may not be severe. But if your head is unprotected, and this happens frequently with the elderly and people under the influence of alcohol or drugs, a direct impact can be fatal,” Prof Ng said.

Don’t dismiss a blow or bump to the head

After a head injury is sustained, seek medical attention if:

  • The person is drowsy, irritable, confused or behaves differently.
  • There is nausea or vomiting.
  • There is weakness or numbness in any part of the body.
  • These symptoms may not appear initially, but if they occur within 12 to 24 hours after impact (the danger period for brain trauma), see a doctor without further delay.​

​Ref. Q15