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Physiogenesis and Psychogenesis in the ‘Post-Concussional Syndrome’

  • W. A. Lishman (a1)

The aetiological factors relevant to the development of post-concussional symptoms are reviewed. From the numerous studies carried out to date, it would appear that both physiogenic and psychogenic influences are important in their genesis. However, where mild-to-moderate injuries are concerned, organic factors are chiefly relevant in the earlier stages, whereas long-continued symptoms are perpetuated by secondary neurotic developments, often of a complex nature.

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Adler, A. (1945) Mental symptoms following head injury. Archives of Neurology and Psychiatry, 53, 3443.
Black, P., Jeffries, J. J., Blumer, D., Wellner, A. & Walker, A. E. (1969) The post-traumatic syndrome in children In The Late Effects of Head Injury, ch. 14 (eds Walker, A. E., Caveness, W. F. & Critchley, M.). Springfield, Illinois: Thomas.
Brain, W. R. (1942) Discussion on rehabilitation after injuries to the central nervous system. Proceedings of the Royal Society of Medicine, 35, 302305.
Dencker, S. J. (1958) A follow-up study of 128 closed head injuries in twins using co-twins as controls. Acta Psychiatrica et Neurologica Scandinavian (suppl. 123), 1125.
Dencker, S. J. (1960) Closed head injury in twins. Archives of General Psychiatry, 2, 569575.
Ewing, R., McCarthy, D., Gronwall, D. & Wrightson, P. (1980) Persisting effects of minor head injury observable during hypoxic stress. Journal of Clinical Neuropsychology, 2, 147155.
Goldstein, K. (1942) After Effects of Brain Injuries in War. New York: Grune and Stratton.
Goldstein, K. (1952) The effect of brain damage on the personality. Psychiatry, 15, 245260.
Gronwall, D. & Wrightson, P. (1974) Delayed recovery of intellectual function after minor head injury. The Lancet, ii, 605609.
Guttmann, E. (1946) Late effects of closed head injuries: psychiatric observations. Journal of Mental Science, 92, 118.
Heiskanen, O. & Sipponen, P. (1970) Prognosis of severe brain injury. Acta Neurologica Scandinavica, 46, 343348.
Jenkins, A., Teasdale, G., Hadley, M. D. M., MacPherson, P. & Rowan, J. O. (1986) Brain lesions detected by magnetic resonance imaging. The Lancet ii, 445446.
Jones, R. K. (1974) Assessment of minimal head injuries: indications for in-hospital care. Surgical Neurology, 2, 101104.
Kay, D. W. K., Kerr, T. A. & Lassman, L. P. (1971) Brain trauma and the post-concussional syndrome. The Lancet, ii, 10521055.
Kelly, R. & Smith, B. N. (1981) Post-traumatic syndrome: another myth discredited. Journal of the Royal Society of Medicine, 74, 275277.
Kerr, T. A., Kay, D. W. K. & Lassman, L. P. (1971) Characteristics of patients, type of accident, and mortality in a consecutive series of head injuries admitted to a neurosurgical unit. British Journal of Preventive and Social Medicine, 25, 179185.
Keshavan, M. S., Channabasavanna, S. M. & Reddy, G. N. (1981) Post-traumatic psychiatric disturbances: patterns and predictors of outcome. British Journal of Psychiatry, 138, 157160.
Lewis, A. J. (1942) Discussion on differential diagnosis and treatment of post-contusional states. Proceedings of the Royal Society of Medicine, 35, 607614.
Lidvall, H. F., Linderoth, B. & Norlin, B. (1974) Causes of the post-concussional syndrome. Acta Neurologica Scandinavica, Suppl. 56, 1144.
Lishman, W. A. (1968) Brain damage in relation to psychiatric disability after head injury. British Journal of Psychiatry, 114, 373410.
Lishman, W. A. (1973) The psychiatric sequelae of head injury: a review. Psychological Medicine, 3, 304318.
Lishman, W. A. (1978) Psychiatric sequelae of head injuries: problems in diagnosis. Journal of the Irish Medical Association, 71, 306314.
McMillan, T. M. & Glucksman, E. E. (1987) The neuropsychology of moderate head injury. Journal of Neurology, Neurosurgery and Psychiatry, 50, 393397.
MacFlynn, G., Montgomery, E. A., Fenton, G. E. & Rutherford, W. (1984) Measurement of reaction time following minor head injury. Journal of Neurology, Neurosurgery and Psychiatry, 47, 13261331.
Miller, H. (1966) Mental after-effects of head injury. Proceedings of the Royal Society of Medicine, 59, 257261.
Montgomery, A., Fenton, G. Q. & McClelland, R. J. (1984) Delayed brainstem conduction time in post-concussional syndrome. The Lancet, i, 1011.
Newcombe, F. (1983) The psychological consequences of closed head injury: assessment and rehabilitation. Injury, 14, 111136.
Noseworthy, J. H., Miller, J., Murray, T. J. & Regan, D. (1981) Auditory brainstem responses in post concussion syndrome. Archives of Neurology, 38, 275278.
Oppenheim, H. (1889) Die Traumatischen Neurosen. Berlin.
Pilowsky, I. (1985) Cryptotrauma and ‘accident neurosis’. British Journal of Psychiatry, 147, 310311.
Robinson, R. G., Kubos, K. L., Starr, L. B., Rao, K. & Price, T. R. (1984) Mood disorders in stroke patients. Importance of location of lesion. Brain, 107, 8193.
Rowe, M. J. & Carlson, C. (1980) Brainstem auditory evoked potentials in postconcussion dizziness. Archives of Neurology, 37, 679683.
Ruesch, J. & Bowman, K. M. (1945) Prolonged post-traumatic syndromes following head injury. American Journal of Psychiatry, 102, 145163.
Russell, W. R. (1932) Cerebral involvement in head injury. Brain, 55, 549603.
Rutherford, W. H., Merrett, J. D. & McDonald, J. R. (1977) Sequelae of concussion caused by minor head injuries. The Lancet, i, 14.
Selzer, M. L., Rogers, J. E. & Kern, S. (1968) Fatal accidents: The role of psychopathology, social stress, and acute disturbances. American Journal of Psychiatry, 124, 10281936.
Steadman, J. H. & Graham, J. G. (1970) Head injuries: an analysis and follow-up study. Proceedings of the Royal Society of Medicine, 63, 2328.
Symonds, C. P. (1937) Mental disorder following head injury. Proceedings of the Royal Society of Medicine, 30, 10811092.
Tarsh, M. J. & Royston, C. (1985) A follow-up study of accident neurosis. British Journal of Psychiatry, 146, 1825.
Taylor, A. R. & Bell, T. K. (1966) Slowing of cerebral circulation after concussional head injury. The Lancet, ii, 178180.
Waddell, P. A. & Gronwall, D. M. A. (1984) Sensitivity to light and sound following minor head injury. Acta Neurologica Scandinavica, 69, 270276.
Waller, J. A. (1968) Holiday drinking and highway fatalities. Journal of the American Medical Association, 206, 26932697.
West, J. R., Lind, M. D., Demuth, R. M., Parker, E. S., Alkana, R. L., Cassell, M. & Black, A. C. (1982) Lesion-induced sprouting in the rate dentate gyrus is inhibited by repeated ethanol administration. Science, 218, 808810.
Whitlock, F. A., Stoll, J. R. & Rekhdahl, R. J. (1977) Crisis, life events and accidents. Australian and New Zealand Journal of Psychiatry, 11, 127132.
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Physiogenesis and Psychogenesis in the ‘Post-Concussional Syndrome’

  • W. A. Lishman (a1)
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