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Dr. Navitsky
Dr. Navitsky, Board Certified Pediatrician
Category: Pediatrics
Satisfied Customers: 1037
Experience:  US Pediatrician licensed in California living abroad.
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Hi, my 16 month old is at the stage where she is starting to

Customer Question

Hi, my 16 month old is at the stage where she is starting to walk and climbing up on her sisters tollar bed and jumping, before we could reach her she fell down from toddlar bed and fell on to the corner of our bed,(the metal frame corner)..

then she started to scream so loud and then we grabbed her and then notice right away that her big vein on her left side of the neck had a huge budge of her big neck vein. i took a youtube video of it for you to view...

http://www.youtube.com/watch?v=n8lAy8TuC2g

please view the video and let me know your thoughts this happened within the last 15mins ago and now she is fine and wanting to get back on the bed and jump, but im worried about her neck..
Submitted: 3 years ago.
Category: Pediatrics
Expert:  Dr. Gupta replied 3 years ago.

PediatricMD : Hello & welcome to Just Answer!<br><br>If you have any questions after reading my answer, be sure to let me know.
PediatricMD : It seems like the trauma has caused the formation of an aneurysm over the External Jugular Vein (EJV)
Customer: hello
PediatricMD : If the swelling persists I would encourage you to take her to the ER/ Urgent care so that this can be confirmed
PediatricMD : Hi
PediatricMD : Seems like some problem in chatting
PediatricMD : Did you get my reply
PediatricMD : ?
Customer: no i did not
Customer: what did you say
PediatricMD : It seems like the trauma has caused the formation of an aneurysm over the External Jugular Vein (EJV), If the swelling persists I would encourage you to take her to the ER/ Urgent care so that this can be confirmed
Customer: how can i be for certain without going to the er
Customer: what signs do i need to look for
PediatricMD : It can be tough to explain how to confirm this to a non medical professional
PediatricMD : However, the location, and the fact that the size increases on crying suggest that this is the possible cause
Customer: what can happen to her if that is the case and it goes un treated
PediatricMD : You would need to look for increasing size, pain in the swelling, and excessively irritable child as possible things
PediatricMD : It may resolve without treatment
PediatricMD : it may remain like this for a long time
PediatricMD : or rarely it may cause local problems like bleeding, increasing swelling etc.
Customer: so if i took her to the ER right now what would they do any tests or anything or just look at it to know what it is
PediatricMD : If the child is absolutely fine, you may show to the Pediatrician too, however given that this is a weekend, I would suggest confirming the same at least once
PediatricMD : You can see this link for some more inputs ... though the problem is slightly different, the photographs are similar
PediatricMD : http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3633282/
Customer: so they just do an ultrasound to find out for certian?
PediatricMD : Yes,
Customer: ok
PediatricMD : that is one of the easily doable tests
Dr. Gupta, Pediatrician
Category: Pediatrics
Satisfied Customers: 7884
Experience: MD, practicing Pediatrician with 19 years of experience. Member American Academy of Pediatrics.
Dr. Gupta and other Pediatrics Specialists are ready to help you
Customer: replied 3 years ago.
Relist: Other.Would like second opinion.
Expert:  Dr. Navitsky replied 3 years ago.
Hi are you still up?
Expert:  Dr. Navitsky replied 3 years ago.
I agree with the above expert as to what the lump may be but have a few questions for you. What part did she hit on the metal bed frame? From what you posted prior I get that maybe the extreme crying after the fall and hurting herself made the lump pop out. Did she hit the neck area at all? I looked at the video and don't see any obvious bruising there...What does the lump feel like...is it soft and compressable or is it hard and you can roll around the circumference of it with your finger? She is still most likely acting totally fine but just to make sure I'll ask again. Thanks!
Expert:  Dr. Navitsky replied 3 years ago.
I was hoping I could catch you online still with the above but let me leave you a generic answer and then let me know by replying if you need anything further. From the appearance I think that the lump is most likely soft and compressable (but feeling in this case you would be able to tell me for sure). You can see clearly how it increases in size when she is crying and this is the thing that points most likely to a lesion in her neck vein which is when the wall is weak and excess pressure causes it to pop out a bit (aneurysm). Neck vein aneurysms are in her age are much more likely to be congenital than caused by minor trauma and based on what I saw I don't think that she hit that part of her neck. The large majority of these are benign and get "fixed" surgically more for cosmetic reasons rather than medical ones. Thus as long as she is feeling fine I don't think you need to rush out to the ER tonight and get it looked at. If she continues to be fine and the area is not changing and may actually decrease in size after she calms down and more time passes then this would be something I would discuss with her pediatrician early on in the week. If it goes away entirely I would still have her pedi see her and the video. If the lesion is hard and you can run your fingers around it it is possible that something underneath the vein is sticking up (like a lymph node) and because of the crying and valsalva (pushing out or bearing down as in crying) and increased blood flow you saw it. If this is the case again I would have it looked at this coming week but not a reason to go to the ED. Hope this helps as a second opinion. Let me know if you need anything further!
Dr. Navitsky, Board Certified Pediatrician
Category: Pediatrics
Satisfied Customers: 1037
Experience: US Pediatrician licensed in California living abroad.
Dr. Navitsky and other Pediatrics Specialists are ready to help you
Customer: replied 3 years ago.
Hi there, so I took her to the er and the doc said that it is normal caused from crying but he still wants her to stay for 4 hours there sleeping and wants to see her reaction after he wakes her up. so anyhow we were just scared but seams everything is ok... thanks for your answer
Expert:  Dr. Navitsky replied 3 years ago.
You are welcome I hope everything does end up being ok above all! She is beautiful by the way. Good luck!

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