Mild head injury--a positive approach to management

It is estimated that 1.4 million patients each year attend Accident and Emergency (A&E) departments in the UK with a head injury. The vast majority are, in retrospect, diagnosed as a 'mild' injury. There is evidence to suggest that many develop short term morbidity and some long term problems. The incidence is unknown. Early recognition and treatment many hasten recovery. A national postal survey of A&E departments revealed a general unawareness for this morbidity. Written advice given to patients on discharge from the departments was exclusively concerned with the symptoms expected if serious complications developed. A description of the common symptoms of fatigue, poor memory and concentration were not given to the patients in a written format. Arrangements for follow up are, in the majority of hospitals, unstructured. We recommend a positive approach to the management and follow up of mild head injury. This should recognize the common problems experienced by these patients and cater for their needs. More interest and research is required into this aspect of head injury.