[Long-term results after surgical treatment of head injuries]

It outflows from a survey of 174 cases operated during five years for skull injuries that the resulting state depends of preoperative level of consciousness. In injuries with the loss of consciousness, there is a close correlation between the type of motor-topain response and the resulting state. It was stated from the delay for up to 5 years after surgery that the independence from the day life has been achieved in 65% of injured patients which experienced preoperatively a mild loss of consciousness as they localized the pain stimulus or produced unintelligible sounds in response to pain. The similar condition has been achieved in only 14% cases of preoperatively deep loss of consciousness, which responded to pain or not with decerebrative extension, or unconsciously flexion of extremities. The resulting state is less dependent of operative diagnosis. Epidural hematomas show better results, where the independence of the day life has been achieved in 62% of cases. The majority of them was able to perform their previous working activities later on. In contrast, the worst results were achieved in association with brain contusions, where only 18% of injured patients sustained the independence of environs with no return to the previous work. Prognostically, the factor of age is the most important. In the age group over than 60 years, the mortality represented 58%, whereas in 20-40 years of age it was only 24%.