Overview of head injuries.

Serious injury to the head is a national health problem with enormous emotional, fiscal, and physical consequences. For this special issue of PHYSICAL THERAPY, serious head injury is defined as trauma to the head with presumed brain involvement. Complete statistical data about head injury in the United States are not available. In the last decade, two national surveys have been done to determine, among other things, incidence and frequency of head injury. Because of study methods and the lack of uniformity in the operational definition of head injury, epidemiologic and demographic data can only be estimated. According to estimates from all available sources, 400,000 people a year in the United States will require hospitalization after head injury and 30,000 to 40,000 persons will require rehabilitation. Consistently in published statistics, at least twice as many men as women sustain head injuries, and the majority are between 15 and 24 years old. Because motor vehicle accidents are the single most frequent cause of head injuries, a significant number of persons sustain multiple-system trauma that mandates care by many medical specialists." Tremendous health-care resources are required in the acute phase of injury and in the rehabilitation process, which may extend from months to years for follow-up care of this young-adult population. The complexities of their postacute care is best provided by specialized centers, which have an experienced multidisciplinary team for the patients' management. Seriously head-injured persons present a challenge to the skills and ingenuity of the most experienced professional. The patients' problems are many—medical, physical, cognitive, linguistic, psychological, social, and vocational. When these problems are addressed collectively by a skilled team committed to a mutually determined common goal, the result is an improved quality of life for the headinjured person. In 1980, the National Head Injury Foundation (National Head Injury Foundation, Inc, 280 Singletary Lane, Framingham, MA 01701) was established as an advocacy and support group for head-injured patients and their families. Many states have chapters that serve as a resource for patients, their families, and health professionals. The following articles on the unique problems of the adult after serious head injury emphasize the multifaceted nature of the problems and provide information that will help the physical therapist in planning and implementing effective treatment within a team concept.