Falls & Brain Bleeding: The Hidden Danger
When a child falls, external injuries don't tell the whole story. Dr Nor Faizal explains why serious brain bleeding can occur even without visible wounds.
· Updated 29 April 2026
Falls & Brain Bleeding: The Hidden Danger
Many parents do not realise that a child can suffer serious brain bleeding with no obvious external injury. In this short video, I explain why external wounds are not a reliable measure of how serious a head injury is.
Why Can Brain Bleeding Occur Without External Wounds?
A child’s skull is still developing — the bones are more flexible, and the brain moves more freely inside the skull on impact. This means the force of a fall can cause bleeding inside the skull without leaving any visible marks on the outside.
The two most common types of bleeding after head injury:
- Epidural haematoma — bleeding between the skull and the outer brain covering (dura). Can expand rapidly and become life-threatening within hours.
- Subdural haematoma — bleeding between the dura and the brain surface. Slower to develop but equally dangerous if left untreated.
Warning Signs to Watch For
Take your child to hospital immediately if you notice any of the following after a fall or blow to the head:
- Loss of consciousness, even briefly
- Repeated vomiting (more than once or twice)
- Unusual drowsiness or difficulty waking
- Headache that is worsening
- Seizures or uncontrolled movements
- Eyes that are not tracking equally, or unequal pupil sizes
- Difficulty speaking or recognising familiar people
Remember: A child who appears fine immediately after a fall can deteriorate within hours. Do not wait.
When to Go Straight to A&E
If the head injury involves a child under 2 years old, or if the fall was from a height greater than 1 metre — go to hospital, even if the child seems well.
Book a Consultation
If you have concerns about a child’s head injury or have questions about paediatric neurosurgery, contact my clinic at KPJ Tawakkal Specialist Hospital, Kuala Lumpur.