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The psychological consequences of head injury in road accidents

This chapter focuses on aspects of head injury which relate specifically to road accidents. The pathology of head injuries arising from road accidents typically differs from that arising from other causes, such as falls and assaults. Brain injury in road accidents typically leads to immediate loss of consciousness at the time of injury. Recovery of consciousness is followed by a period of post-traumatic amnesia (PTA), when the person is alert and may be able to converse, but has lost continuous memory. After normal day-to-day memory has been recovered, cognitive abilities usually improve gradually, but some deficits can persist indefinitely. Although most road accident head injuries are minor, they can lead to significant psychological difficulties, including post-concussion syndrome, for some months. The author analysed data about 103 patients in Scotland, with head injuries from road accidents or other causes. Despite their high proportion of severe initial injuries, 69% of those injured in road accidents had recovered well at six months. In comparative neuropsychological tests given to 55 patients, the road accident patients tended to have better cognitive recovery, but more permanent slowing of mental processes, consistent with the view that diffuse axonal injury was their dominant pathology. For the covering abstract, see IRRD 893642.