The Mental Manifestations of Head Injuries in Children

1. A case of hypophyseal and hypothalamic damage is recorded in which there was no history or signs of diabetes insipidus. 2. It is suggested that the anterior hypophysis plays an essential part in the production of a permanent polyuria. Hon. Physician with charge of outpatients , Ulster Hospital for Children and Women, Belfast JENTA.L; chainges followinog head injuries may be classified as temporary and)ermanent. Temporary changes are commion, and indeed almost any severe head injury is accompanied by a series of these mental changes which conform to a definite pattern. The patient who survives gradually returns to normal, although convalescence is prolonged and possibly retarded by the condition known as post-traumatic psychosis (Symonds), or receding dementia (Martin). The frequency of the temporary mental change following severe head injury is in acute contrast to the rarity of permanent mental change. Looking over the records of all cases of head injuries admitted to the wards of the Royal Victoria Hospital, Belfast, in the past five years, I found only one in which mental change, seenmingly permanenit, was recorded. In considering this subject as applied to children, several important questions suggest themselves. What is the frequency of permanent mental changes in children? Does this change conform to any particular pattern? What is the lesion, if any? Or to what can one attribute the cause? 119