MINOR HEAD-INJURY - PATHOPHYSIOLOGICAL OR IATROGENIC SEQUELAE

This study addresses the possibility that cognitive sequelae-albeit of a transient or minor character-can be associated with mild head injur y. Twenty men (aged 16-30 years of age), whose post-traumatic amnesia did not exceed eight hours, were examined within 48 hours of their acc ident and again one month later. This unselected sample had no previou s history of head injury. A control group of 20 men of similar socioec onomic background, was selected from medical wards (where they had bee n admitted for orthopaedic treatment or a minor operation). They were also retested one month after the first examination. Neuropsychologica l tests were selected to measure abilities often compromised after sig nificant head injury, namely memory and attention. The experimental co mponent consisted of the fractionation of a complex skill (paced addit ion) to probe for deficits at different stages of information processi ng: perception and input into storage; search for and retrieval of inf ormation from working memory; and paced and unpaced addition. In gener al, no significant difference was found between the experimental and c ontrol groups, with the possible exception of an initial decrement on two working memory tasks: probe digits and a keeping track task (where the subject has to keep in mind and update a number of variables at t he same time). The keeping track paradigm, ostensibly of ecological re levance, may well be worth further exploration in memory research, and in studies of more severely head-injured patients. It is further sugg ested that the appropriate management and counselling of mildly head-i njured patients may help to avert symptoms that are of psychological r ather than pathophysiological origin.