Ask the Pediatric Surgeon: Head Injuries

Elliot Hospital
Dr. Elizabeth Soukup from Elliot Hospital in Manchester, NH

Dear Dr. Soukup, My 2 year old fell off a chair about 10 days ago and hit her head. She was checked out in the ED right away, but is still not acting like herself. Should I still be concerned? – Olivia W.

Dear Olivia,

Before I respond to the medical aspect of your question, I think it is important to embrace your “parent instinct” in situations like this. When you are concerned and something seems “not right” with your child, listen to yourself and seek help! It sounds like your daughter had a concussion, and the evaluation in the ED would have ruled out more significant or dangerous brain injuries. There is a huge scientific organization called PECARN (Pediatric Emergency Care Applied Research Network) which has studied hundreds of thousands of children to identify those who are at highest risk for significant injuries. Using data like this can help us choose the children who most benefit from a CT scan, in order to minimize radiation exposure and at the same time, not miss any injuries. Typical symptoms of concussion include headache, nausea and vomiting, dizziness or balance problems, fatigue, sensitivity to light and noise, and disturbances in emotion and sleep. Our littlest kids demonstrate these symptoms as fussiness and unwillingness to eat. Most kids recover quickly from a concussion but it can sometimes take substantially longer, rarely even weeks or months to return to normal behavior. Although we consider concussion a “mild” traumatic brain injury, it is still a serious event. The CDC recently published guidelines on the diagnosis and management of pediatric concussion, including recommendations regarding rest and gradual return to activities, as well as avoidance of repeated injuries, which can be much more serious. As we are well into ski and snowboard season, I’ll use this opportunity to plug for helmet use while participating in these high intensity sports! Prevention is the best cure. Click here for a helpful handout on concussion made by the CDC. Thanks for your question!

Dr. Soukup earned her Bachelor of Science from the Massachusetts Institute of Technology and her Doctor of Medicine from the University of Chicago Pritzker School of Medicine, where she received the Outstanding Achievement Award in Medicine, graduating first in her class. She completed her General Surgery training at the Massachusetts General Hospital and her fellowship in Pediatric Surgery at Children’s Hospital Boston. During her time in Boston, she also completed a Masters of Medical Sciences degree in clinical investigation from Harvard Medical School. She was awarded Elliot Hospital’s “Physician of the year” for 2018. She is board-certified in both Pediatric Surgery and General Surgery. She has specialized training and experience in minimally invasive surgical treatment for babies, children and teenagers. Her practice includes all areas of general pediatric surgery, including common pediatric surgical problems as well as neonatal surgery, congenital anomalies, minimally invasive surgery, and complex thoracic surgical problems.

Elizabeth S. Soukup, M.D., M.M.Sc. Pediatric Surgeon Dr. Soukup is a Pediatric Surgeon at the Elliot Hospital and has an interest in educating families about pediatric health and wellness. Her mission is to provide expert specialty care for children of all ages in New Hampshire – newborns through teenagers – striving to keep them close to their families and communities. If you would like more information, call 603-663-8393 for an appointment, or visit our website at Check out her previous articles at #askthepediatricsurgeon.

Please send your questions to: [email protected]

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