PEDIATRICS Vol. 77 No. 2 February 1986, pp. 251
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Acute Medical Care of Severe Head Injury Is Not Enough

JOHN M. FREEMAN MD1

1 Department of Pediatrics and Neurology, The Johns Hopkins Hospital, Baltimore

As indicated by Jacobson et al in this issue (Pediatrics 1986;77:236) significant head trauma is a major and frequent occurrence in adolescents and in younger children as well. The major advances in emergency medical services—helicopter transport, trauma centers, and management of increased pressure—has had dramatic effects on the survival rate and, probably, on the quality of survival of children with closed head injury. However, discharge from the hospital of a child who is able to walk, although often considered the end point by the surgical team, is clearly not sufficient for the parent and child.

As Jacobson and his colleagues indicate, discharge is not the end but the start of many problems.


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