The development of a concept of mild head injury

Abstract

Medical and literary sources have described head injury and its effects from early Egyptian times. Though milder injury - concussion - must have been familiar, there was little specific written about it until the latter part of the 18th century. Descriptions of persisting symptoms appear in the 19th century, and discussion of their origin and management has continued and intensified since then. There have been several major issues. How does mechanical trauma produce a temporary loss of neurological function and is there some lasting damage? When symptoms persist do they follow a pattern which we recognise as occurring with structural lesions, or are the symptoms a functional reaction to the injury and other life events? Are they both?Over the last 50 years these issues have been debated, often with heat. Whatever the final judgment the present task would seem to be to provide a service to deal with the clinical situation.