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In 1999, the Royal College of Surgeons updated the guidelines on the management of patients with head injury first issued in 1986.1,2 Prior to this, several other societies in the UK and elsewhere had released similar guidelines, preceded by research in Canada. National guidelines should lead to change of patient management.3 The latency of guideline effects was recently shown by a report in this journal.4 Repeatedly revised guidelines, …
Competing interests: None declared.