How to deal with head injury in children with hemophilia?

Question

Hello doctor,

I am worried about my 6-year-old son, who has severe hemophilia A and recently started school. Recently, his teacher called to say he fell during recess, hit his head, and developed a goose egg. He did not lose consciousness, but I am concerned about internal bleeding. I gave him factor VIII at home right away, but should we take him to the hospital? He has been complaining of a headache since then.

Also, his port site looks red and tender; could it be infected? How do we balance keeping him safe while letting him have a normal childhood? He is already feeling different from his classmates, and the school nurse seems nervous about handling his condition. At what point does a head injury become an emergency for a child with hemophilia?

Please help.

Answer 1

Hi,

Welcome to icliniq.com.

I read your query and can understand your concern.

With hemophilia A (a genetic bleeding disorder caused by a deficiency of factor VIII), any head injury requires close monitoring due to the risk of internal bleeding, even if there is no loss of consciousness. Since your son has a persistent headache after his fall, it is important to take this seriously. Headaches can be an early sign of a brain bleed, so consulting his hematologist or going to the ER (emergency room) for evaluation is recommended.

Additionally, the redness and tenderness at his port site may indicate an infection, which should be checked as soon as possible. Infections at a port site can quickly become serious and may require antibiotics or further medical intervention.

Balancing safety with a normal childhood can be challenging. It is essential that school staff, especially the nurse, understand his condition, emergency protocols, and when to administer factor VIII. Protective gear, like a helmet for high-risk activities, can also help minimize injuries.

While allowing him to participate in daily activities is important for his emotional well-being, safety precautions should always be in place. If symptoms worsen or new ones appear, seek medical attention immediately. When in doubt, always be cautious and consult his medical team.

I hope this helps.

Kindly revert so I can assist you further.