Head injury remains a major cause of death, especially in the young. Many die in the initial impact. Of those who survive and remain in coma for 6 hours, 40% die within 6 months.
Recovery depends upon the nature of the injury. Residual effects are both physical, e.g. hemiparesis, dysphasia; and mental, e.g. impaired intellect, memory, and behavioural problems.
The extent of recovery is often correlated with the duration of post-traumatic amnesia. As a guide, post- traumatic amnesia of more than 28 days is rarely associated with a return to work. Post-traumatic amnesia of more than one week is likely to impair higher intellectual activity. That of less than one day should allow a return to previous activity after several months. The prognosis is better for younger patients, worse for older ones.
Most of the improvement is within the first 6 months. Physiotherapy and occupational therapy have important roles, both in overcoming physical disability and in stimulating motivation.
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