A cohort of 2747 patients with head injuries was followed for 28,176 person-years to determine the magnitude and duration of the risk of posttraumatic seizures. Injuries were classified as severe (brain contusion, intracerebral or intracranial hematoma, or 24 hours of eight unconsciousness of amnesia), moderate (skull fracture or 30 minutes to 24 hours of unconsciousness or amnesia), and mild (briefer unconsciousness or amnesia). The risk of posttraumatic seizures after severe injury was 7.1% within 1 year and 11.5% in 5 years, after moderate injury the risk was 0.7 and 1.6%, and after mild injury the risk was 0.1 and 0.6%. The incidence of seizures after mild head injuries was not significantly greater than in the general population.

Records in the Mayo Clinic linkage system were reviewed to determine the incidence of head trauma in Olmsted County, Minnesota, from 1935-1974. Minimum criteria for inclusion--loss of consciousness, posttraumatic amnesia, or skull fracture--were met by 3587 cases. During the decade from 1965-1974, the age-adjusted incidence rates per 100,000 population were 270 in males and 116 in females. The rate was highest--658--in males aged 15 to 24, but it was at least 50 in all age and sex groups. Major causes of head injury were automobile accidents (37%) and falls (29%). The incidence of head injuries related to automobiles and recreation has been increasing, whereas most other categories have remained stable or have declined. Of all cases, 446 were fatal, the average annual incidence being 32 per 100,000 in males and 9 per 100,000 in females. Among the groups at high risk of head trauma are those who have had head trauma previously.

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Neurologic and psychometric findings in the Brachmann-de Lange-syndrome. Neuropadiatrie 3 : 46-66 (1971). A muiltidisciplinary investigation of the BRACHMANN-DE LANGE-syndrome (BDLS) reports neurologic, genetic, electroencephalographic, and psychometric data on 19 subjects. Although findings such as microbrachycephaly, broad-based and poor tandem gait, strabismus, nystagmus, tight heel cords, and dyssynergia of reach were common, there were no pathognomonic neurologic findings. Approximately 20%> of the patients had histories of a seizure disorder. IQ scores ranged from 4 to 85, and 8O°/o of the patients were severely or profoundly retarded. The four patient's with IQ levels that exceeded 35 had higher birth weights and higher total ridge counts than did the remaining patients. The two patients with head circumference equal to, or greather than, the second percentile for age and sex had IQ scores that substantially exceeded the group mean. In support of previous reports based on smaller numbers of subjects, the present study shows that the degree of associated mental retardation in patients with the BDLS is not necessarily severe and that the BDLS is compatible with survival into adulthood.Brachmann-de Lange-syndrome malformation syndrome mental retardation seizures and EEG abnormalities Detailed investigations of the cause of apparent neurologic disabilineuropsychologic manifestations of ties, mental retardation, and occasionthe BRACHMANN-DE LANGE-syndrome al behavioral disturbances in patients (BDLS) have not been reported to with the BDLS; at the same time, date. Neurologists, psychologists, and these consultants are impressed by the psychiatrists are at times consulted be-frequently striking additional mani-

A study of the total cost of head injury in Olmsted County, Minnesota, with the costs projected to the United States population, revealed that the annual cost for head trauma in the US can be estimated at approximately $12.5 billion using a 6 per cent IntroductionAbout 75 million Americans are injured every year and, in 1977, 150,000 died of injury.' In 1982, there were about 165,000 deaths due to trauma.2 Head injuries are the cause of a substantial percentage of trauma-related mortality and morbidity. Knowledge of the direct and indirect costs related to head injury may contribute to the implementation of appropriate programs of prevention.