The clinical outcome of patients with severe head injuries, treated with highdose dexamethasone, hyperventilation and barbiturates.

The outcome in 45 consecutive patients following severe head injuries is presented. All patients were evaluated according to the Glasgow Coma Scale and the Glasgow Outcome Scale. All patients received a combined treatment consisting of dexamethasone, barbiturate and hyperventilation. A primary operative intervention was performed in 14 patients with intracranial haematomas. There was a good recovery in 53%, 20% were moderately disabled, 11% were severely disabled. 16% died or remained in a vegetative state. The patients were aged between 5 and 83 years, 49% were under 20 years, and the relationship between age and outcome was demonstrated. 86% of the patients under 20 years and 60% over 20 years made a good recovery. These results indicate that a more favourable prognosis is possible after severe head injury, especially in children and thus the combined treatment described above appears justified.