Prognosis of Severe Brain Injury

The data concerning the mortality in severe brain injury and the disability caused by it were analysed. We classified as severe those head injuries which caused unconsciousness for more than 24 hours. The series presented consists of 204 patients. The follow-up time was from three to five years. The total mortality was 50 per cent, but increased steeply in older age groups. The mortality in patients over 60 years of age was 78 per cent, but among those under 20 years it was 38 per cent. Three years after the injury 43 per cent of the survivors were totally disabled. Less than 30 per cent of patients over 50 years of age were able to return to their former work, whereas more than 70 per cent of patients under 20 years were able to return to work or to school. It is concluded that in patients over 60 no special or heroic methods of treatment are indicated but that in children and adolescents every effort should be made as long as there has not been respiratory arrest and cerebral death.