Urban head injury: a clinical series

Consecutive head-injured patients admitted to Cook County Hospital in Chicago, Illinois, over a 12-month period were examined upon admission and discharge. Information was collected about the nature of the injury, symptoms, signs, and sequelae for 702 patients. Detailed descriptions of the causes of these injuries, and their correlates, were also obtained.Approximately 80 percent of the patients had localized pain, loss of consciousness and/or posttraumatic amnesia, and associated injuries; 16 percent had a skull fracture, 7.0 percent had an intracranial hematoma, 4.1 percent had early seizures, and 2.4 percent died.Skull x-ray examinations were performed on 93.4 percent of the patients (16.9 percent were positive) and radiographic examination of the cervical spine was performed on 67.2 percent (1.7 percent were positive). Utilization of EEGs, computerized tomography scans, and arteriograms was also assessed.Falls were the leading cause of injury (45.8 percent) for patients under 16 years of age and interpersonal injuries accounted for the majority (55.7 percent) of the injuries to adults. About 15 percent of the adults sustained severe or fatal injuries, compared with only 7 percent of the children.It is concluded that although this set of data suggests new considerations for the prevention of head injuries, the lack of comparative data about the medical correlates of these injuries inhibits similar observations about medical care.