Long Term Prognosis in Closed Head Injury

The purpose of this survey was to investigate the likelihood of return t0 normal life and employment in patients who had suffered a head injury causing impaired consciousness for over twenty-four hours. In order to confine the study to those in whom unconsciousness could be attributed to direct injury to the brain at the time of the accident, patients with intracrania' haematoma resulting in cerebral compression, and those with severe multip'e injuries were excluded. It was considered important to allow a period of fiv? years for follow-up purposes. On the basis of these criteria one hundred and forty patients admitted to the Neurosurgical Unit at Frenchay Hospita' between January 1st 1950 and December 31st 1959 were reviewed. They wer<j classified on the basis of the depth of unconsciousness at the first recorded examination and the time elapsing before full consciousness was regained. the one hundred and forty patients whose case records were studied, forty-t^ died without regaining consciousness, leaving ninety-eight for follow-up. 1 must be stressed that these cases form a selected group in so far as they were referred to a specialist unit, usually for suspected intracranial complication and cannot be considered typical of closed head injuries in general. The follow-up was conducted by a postal questionnaire, and replies werjj received from the patient, a near relative and/or the patient's doctor, in cases. The analysis was based on the information supplied concerning these; 78 survivors; some of this may be highly subjective and of doubtful accuracy-