[Mild brain injuries: definition, classifications and prognosis]. / Traumatismes crâniens légers: définition, classifications, pronostic.

Brain injuries may be graded into mild, moderate and severe depending on clinical and radiological criterions. Mild brain injuries (MBI) are usually defined by an initial unconsciousness limited to 30 minutes, a Glasgow score between 13 and 15, the absence of intra-cranial lesion on the CT scan, a post-traumatic amnesia period between one and 24 hours depending on the authors. The consequences of a MBI may be simple but the injured often suffer from a transitory post-concussive syndrome. Traumatic stress states are a well known pathology and consist in a psychological reaction against the trauma. The acute traumatic stress may or may not run its course to a chronic post-traumatic stress disorder, formerly called post-traumatic neurosis.

[Clinical scoring scales for brain injury]. / Méthodes d'étude clinique des traumatismes crâniens.

The development of data processing techniques has enabled the establishment of large databanks on brain injury. Clinical features are described with clinical scoring scales, the main one being the Glasgow Coma Scale. Three types of patient response are analyzed: eye opening, oral answers, active muscular reaction. The advantages and disadvantages of each are presented. Others scales have been proposed but are not in common use. Several classifications have been established combining depth and length of coma. Post-traumatic amnesia, i.e. the period of time running from the injury to recovery of anterograde memory, constitutes the most important parameter in the classification of these injuries. Generally, three gravity grades are used: mild, moderate and severe brain injuries. Knowledge of the prognosis is essential for determining the most appropriate medical care and is directly related to the quality of the collected data. Five outcome categories can be described.

[Psychological aspects of facial trauma]. / Aspects psychologiques des fracas faciaux.

The anatomic lesions resulting from facial trauma have serious psychological implications. The topic can be divided into three parts. First, the psychological trauma begins by a simple conception of the psychic structure. Secondly, an external crust protects an inner structure whose role is to maintain a vital function and a pleasure function. Thirdly, the face materializes these two functions. Facial trauma totally disrupts the external crust with staggering psychic implications, releasing the archaic process of survival. After this initial event, a second step is required where the trauma is interiorized leading to a highly variable clinical course which involves recovery, disturbed memory, and a depressive syndrome. The clinical manifestations and possibilities for preventing the post-commotional syndrome are also discussed together with the psychological disorders implied with facial traumatism: disorders linked to the perception of the face, esthetic damage, neurological and sensorial disorders. The course is basically linked to the personality of the patient.