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February 24, 1945


JAMA. 1945;127(8):429-436. doi:10.1001/jama.1945.02860080001001

The relationship between the degree of initial traumatic damage done to the cranium in head injury and the extent of subsequent symptoms directly related to bony injury is usually well defined. For example, the part played by a fracture through the orbit in causing subsequent displacement of the globe of the eye, or by a compound or depressed fracture of the skull in causing a hemiplegia of the opposite side, or jacksonian epilepsy, may be clear. Greater difficulty is encountered in forming an estimate of the degree to which these and less direct physical effects account for disability from a previous head injury. Even more obscure is the relationship of such physical after-effects to more general and less tangible symptoms such as headache and dizziness, intellectual deficit, psychoneurotic states, and changes in character and personality which are frequently associated with disability.

Russell,1 in an analysis of 200 cases of