[EEG and craniofacial injuries]

The number of cases studied was too small to be really representative of the role of the E.E.G. in the assessment of cranio-facial trauma cases. The following points may nevertheless be stressed: -The usefulness of negative findings. The E.E.G. may be used to confirm that a purely facial impact, or one without any severe cranial involvement, has only minor or quite negligeable cerebral repercussions. -The presence of significant E.E.G. changes indicates marked cerebral involvement. The nature of the latter (contusion, haematoma etc.) cannot be determined by the E.E.G. alone but any obvious localising signs (e.g. severe frontal deterioration) should indicate the possibility of a lesion requiring urgent neurosurgical treatment. In particular, sub-frontal extra-dural haematomas are associated with abnormalities clearly localised in the fronto-polar regions (R. Vigouroux et al., 1962). Apart from such specific collections, the type of damage described in operative reports easily explains the major disturbances in the frontal tracing which are almost invariably encountered. -The value of an early E.E.G. examination and of repeated studies. The first record gives an indication of the cerebral "state" and of possible "functional" disturbances which may exist later after the accident. Above all, it represents a valuable prognostic indication, in particular in patients who are in coma, precisely reflecting the depth of the latter and its potential reversibility. The course and progress of initial abnormalities is also an element in prognosis. In our patients, it was surprising to note the ease with which certain initial major disturbances resolved. However the persistence of minor alterations should lead to reserve with regard to the recovery of complete cerebral integrity and such subjects should be carefully followed up.