SUMMARY In a follow up study of 57 patients who had sustained a severe closed head injury, 84% still reported some residual deficit in their psychological functioning after two years, with forgetfulness being the most common complaint. Expressing the severity of the injury in terms of both the duration of post-traumatic amnesia (PTA) and the extent to which previous work could be resumed (RTW), principal components analyses showed that the occurrence of "impairment complaints"-viz forgetfulness, slowness, poor concentration and inability to divide attention over two simultaneous activities-was positively related to severity. The other complaints, which in the main could be labelled as "intolerances" were not. The same pattern was found when the analyses were based on deficits of the patients as they were reported by relatives. Severity was not appreciably related to the total number of complaints. The correlation between PTA and RTW was 052, indicating that with longer PTA duration, work is likely to be resumed at a lower level, or not at all. Though Russell's cut-off of one week PTA to differentiate between severe and very severe concussion appeared useful, in the present study a further cut-off point at the unlucky number of 13 days was considered.The head-injured patient can be viewed as a relative expert in the field of head injury, and examining his or her complaints more fully can serve two goals: firstly, a description of post-traumatic states cannot be complete if the subjective aspects are neglected; secondly, listening to the patient might be helpful in generating hypotheses about the nature of the deficits, hypotheses that can be tested within an experimental psychological framework. The studies to date indicate that after head injury, people may mention a large variety of complaints, such as headache, dizziness, poor memory, poor concentration, fatigue, irritability and anxiety. The majority of these investigations, however, have studied patients who had sustained minor or moderately severe head injuries, with PTA durations of up to a few days.1 The search for stable combinations of complaints, which would justify the word "syndrome" has, however, not been successful with such patients. Lidvall' used the word "polymorphous" when describing the symptom picAddress for reprint requests: AH van Zomeren,

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Performance on Dutch adaptations of Rey's AVLT was examined in a sample of 225 6- to 12-year-old Dutch school children, selected to be representative of the general population. With an interval of 3 months, they were tested twice, using two out of three test forms which proved to be parallel. No test-retest practice effects were apparent. Age had a considerable impact on test performance. Measured imperfectly, socioeconomic background and intellectual level had some additional influence, as did the examiner who administered the tests. Boys made more errors than girls. Normative data corresponded well with those collected in a smaller Australian sample, suggesting usefulness outside The Netherlands. With a parallel test-retest reliability of.70, which was reduced to.59 when the influence of age was taken into account, the most reliable AVLT measure was the total number of words correctly recalled over the five learning trials. On the basis of reliability data, implications for the clinical use of the AVLT are discussed.

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SynopsisIn a group of 20 patients who were to undergo endarterectomy for atherosclerotic occlusive disease of the internal carotid artery, the stenosis did not appear to have resulted in cognitive or motor deficits. Consistent with this finding, surgery could not be shown to have a beneficial effect on cognitive or motor functioning. Control data were supplied by 20 patients who underwent peripheral vascular surgery and 20 healthy subjects. The test-retest interval was 10 weeks.