The Treatment of Head Injuries.

Trauma has become the endemic disease of modem civilisation.  Head injury occurs in 70% of all injuries and causes death in 25%.  The number of significant head injuries is rising year by year as shown by the table of the figures at the Royal Infirmary of Edinburgh.TABLE 1Year             Number1962            8301963            6911964            9411965            10201966           1251In no other system of the body is a knowledge of the functional anatomy more essential than in the diagnosis and treatment of the head-injured.  The brain is contained loosely within the bony skull. It is separated from it by the meninges and by a subarachnoid layer of cerebro-spinal fluid (C.S.F.).  The brain maintains continuity with the bony skeleton by means of the cerebral veins which pass from the cortical surface to the dural sinuses. The width of the space between brain and skull depends on brain bulk.  Thus in states of cerebral atrophy due to age or disease the space will be increased.