[A doctrinaire approach to evaluation of sequelae of craniocerebral injuries]

The consequences of the severe head injuries should be estimated 1-2 years following the injury. The evaluation must be based upon certain postulates which are to be obligatory for the team of experts (neuropsychiatrist, otologist, ophthalmologist, neuro-radiologist, clinical psychologist). They must work simultaneously as a team for it is the only way to establish the precise qualification of the damage in question. The clinical work up to now has shown many weak points. The first postulate is the information on the state of health prior to the injury: previous injuries and their sequelae, psychopathological manifestations, alcohol abuse, disturbances of the consciousness, vertigo, disturbances of the sight and hearing etc. The second postulate is the review of the case history regarding the acute period of the injury: the qualification of the injury, the duration of the state of unconsciousness and post-traumatic amnesia, focal neurological signs, psychological disturbances, EEG, CT etc. The third postulate is a detailed clinical examination including paraclinical parameters neurological examination (focal neurological signs, hemicerebral syndrome and very seldom-parkinsonism) with consultation of otologist (vestibularis, audiogram) and ophthalmologist (visus, fundus, campus, intraocular pressure), EEG (longitudinal follow-up), possible evoked cerebral potentials. The epilepsy syndrome must be based upon clinical and EEG criteria, while the selection must be very strict. In there are structural brain changes the collaboration with the neuroradiologist is important. Psychological disorders: neurasthenic neurosis, personality disorders, and rarely dementia. It should be clinically confirmed accompanied by psychological tests.(ABSTRACT TRUNCATED AT 250 WORDS)