Concerns About Eye Rubbing and Nosebleeds After Child's Head Injury

After my son sustained a head injury, he had a nosebleed the following day, and recently I have noticed him rubbing his eyes?

Hello, my son is currently two years and seven months old.
Over two months ago, he slipped on water on the floor and hit his head.
Since I was not present at the time, I am unsure whether he hit the front or back of his head.
However, I did hear a loud noise at the moment of impact.
When I went to check on him, he was crying but did not lose consciousness.
After the incident, there were no neurological abnormalities, and his appetite and activity levels were normal.
The following afternoon during his nap, he experienced a nosebleed (which was minor and stopped quickly).
We observed him at home without going to the hospital for an examination, and in the following days, there were no unusual symptoms (though he did mention a headache, but it was just a brief comment without any signs of discomfort or crying).
Recently, about two months after the incident, I noticed that he has been rubbing his eyes frequently.
I am concerned whether this could be a residual effect on his vision due to the head injury (especially since he had a nosebleed).
Additionally, I would like to ask how long after a head injury can residual effects appear? Is it still possible to develop residual effects more than two months after the incident? I kindly ask for your clarification.
Thank you.

Claire, 30~39 year old female. Ask Date: 2021/10/11

Dr. Jiang Junyi reply Neurology

Hello Claire,
You mentioned that "a little over two months ago, I slipped on water on the floor and hit my head...
I wonder if this is a consequence of visual impairment due to the brain impact?" Unless there is a severe head injury resulting in loss of consciousness, visual disturbances such as seeing stars are typically temporary phenomena.
Even in cases of intracranial hemorrhage, any bleeding should have been absorbed within two months.
You also mentioned that "I noticed my son frequently rubbing his eyes," which may suggest a common condition like conjunctivitis.
I recommend that you first visit an ophthalmologist for an examination and follow-up.
If there is an issue related to intracranial hemorrhage, increased intracranial pressure can be assessed by the ophthalmologist through the detection of papilledema.
Wishing you and your child good health, safety, and happiness.
Dr.
Jiang Junyi, Taoyuan Medical Center

Reply Date: 2021/10/11

More Info

It sounds like you have some valid concerns regarding your son's health following his head injury. First and foremost, it's important to understand that head injuries in children can sometimes lead to a variety of symptoms, and while many of these symptoms may resolve on their own, some may require further evaluation.

From your description, it appears that your son experienced a significant fall, which can be concerning, especially given the loud noise you heard at the time of the impact. The fact that he did not lose consciousness and showed no immediate neurological abnormalities is a positive sign. However, the subsequent nosebleed and the recent behavior of rubbing his eyes warrant further consideration.

Nosebleeds in children can occur for various reasons, including trauma, dry air, or even allergies. In your son's case, the nosebleed following the head injury could be related to the impact, but it is also possible that it was coincidental. If the nosebleed was brief and not recurrent, it may not be a cause for alarm. However, if it becomes frequent or is accompanied by other symptoms, it would be wise to consult a healthcare professional.

The eye rubbing you mentioned could be due to several factors. It may be related to allergies, irritation, or even fatigue. While it is understandable to be concerned that this behavior could be a sign of a neurological issue stemming from the head injury, it is more likely that it is a separate issue. Eye rubbing is common in young children and can often be attributed to discomfort rather than a direct consequence of a head injury.

Regarding your question about the timing of potential post-injury symptoms, it is important to note that while some symptoms can manifest immediately after an injury, others may take time to develop. Generally, if a child is going to experience significant post-concussive symptoms, they would typically present within the first few days to weeks following the injury. However, there are cases where symptoms can appear later, but this is less common. Since it has been over two months since the injury, it is less likely that new, serious symptoms would arise solely due to that incident.

If you are concerned about your son's eye rubbing or any other symptoms, it would be prudent to consult with a pediatrician or an eye specialist. They can perform a thorough examination to rule out any underlying issues, such as allergies or other ocular conditions. Additionally, if you notice any changes in his behavior, such as increased irritability, changes in appetite, or difficulty concentrating, these could be signs that warrant further investigation.

In summary, while your concerns are understandable, the symptoms you describe may not necessarily indicate a serious issue related to the head injury. However, it is always best to err on the side of caution when it comes to the health of your child. Regular check-ups and open communication with healthcare providers can help ensure that any potential issues are addressed promptly.

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