THE DIAGNOSIS AND MANAGEMENT OF SHOCK IN CLOSED HEAD IMJURY

Shock secondary to closed head injuries alone is unusual, and other causes must be excluded before assuming brain injury to be the cause. The successful management of injuried patients requires a working knowledge of the pathology of shock. Four hundred and twenty two patients with sereve closed head injury were admitted from January, 1972 to December, 1981. In 248 cases （58.7%） shock was present, and only 17（4%） of the patients belong to the shock secondary to head injuries alone. Thus, if shock is present, a seach must be made for its cause. Ruptured intra-abdominal organs or chest trauma may be present, or a loss of sympathetic tone from spinal cord injuries may occur: all these conditions may produce shock. Rarely, serious hemorrhage may occur from the extensive scalp lacerations and lead to hemorrhagic shock.