Long-Term Prognosis After Severe Head Injury
Over the last thirty years we have had the opportunity of treating non-missile head injuries in the setting of a main general hospital with a neurosurgical unit where all head injuries admitted, both minor and major, came under the care of the neurosurgical unit. From 1948 to 1961 a consecutive series of 7,000 cases were admitted to the Radcliffe Infirmary, Oxford, and analysed by a punch card technique. We defined severe head injury as producing unconsciousness or posttraumatic amnesia (PTA) for one week or longer. Among the 7,000 cases in the Oxford series were 479 patients who had sustained a severe head injury under the present definition. All but 11 were traced in a follow-up ten to twenty-five years later. A hundred and seventy-eight patients had died, and the cause of death was established. The remaining 291 patients were examined by an independent team consisting of a neurologist, a clinical psychologist, and a psychiatric social worker. In more than 90% of these patients in the complete survey it was possible also to interview the relatives independently (Lewin, Marshall, and Roberts 1978).
KeywordsHead Injury Physical Disability Severe Head Injury Mental Disability Neurosurgical Unit
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