[32] Traumatic Injuries of the Brain.
[33] Traumatic Injuries of the Brain, p. 138.
[34] System of Surgery, vol. i, p. 179.
[35] American Practice of Surgery, Bryant and Buck.
CHAPTER VI
THE REMOTE EFFECTS OF HEAD-INJURY
General considerations.
It is often stated that a patient who has received a severe head-injury is ‘never the same man afterwards’. Before accepting such a sweeping statement—the gravity of which is obvious—it is essential that an extensive survey should be made into the remote effects of head-injury, and, in their consideration, the surgeon must not be biased by those cases that seek hospital relief. It is the unfavourable cases that present themselves for examination, the more favourable are usually lost to view. Furthermore, whether the early results are completely satisfactory or not, but little guide can be obtained into the more remote results unless, as a routine procedure, an attempt be made to trace all such cases in their after-history. The more remote results can then be estimated at their true value.
The difficulties attendant on all attempts at following up hospital cases are considerable, and consequently we are greatly indebted to Crisp English[36] for his tabulation and discussion on the after-history of 300 cases treated at St. George’s Hospital—300 cases personally investigated at periods varying from one to twenty years subsequent to the time of the injury.
English’s conclusions have been compared with those derived from my own personal experience, with the result that they were found to coincide so closely that they may be accepted as affording an accurate guide into the remote results of head-injury in general.