These patients suffering from chronic headache are often pitiable subjects, spending their time in wandering from doctor to doctor, from hospital to hospital, seeking relief. They are only too eager to obtain benefit from surgical intervention. The greatest care is required in deciding as to operative procedures. Injudicious surgical measures are not only disappointing to both surgeon and patient, but also discreditable to this branch of surgery. On the other hand, it must be acknowledged that remedies other than surgical are generally inefficacious. The surgeon, therefore, takes considerable responsibility on his shoulders when he states that an operation is inadvisable. Though guarded in my prognosis, I generally advise operation on the ground that it is impossible to foretell the cause of the headache, and brilliant results may be obtained. =Treatment.= When the headache is diffuse, REST, aided by the administration of phenacetin, &c., may exercise some effect. Operative treatment should not be recommended unless the intensity of the attack, blurring of the disks, and slowing of the pulse suggest that there is some increase in the general intracranial pressure. Under such circumstances, exploration should be carried out over the region at which the injury was received. In the absence of evidence with respect to external injury, a subtemporal decompression operation is the operation of election. When the pain is localized to some special region, the outlook is more favourable. Operative measures should then always be carried out over the painful spot. A scalp-flap is framed according to the region which it is desired to expose, the disk of bone removed, and the meningeal territory examined. For detailed operative technique, see p. 20. When the pain is referred along the course of one of the scalp nerves, it may be relieved by alcohol injections (see p. 314), or by exposure of the nerve, followed by removal of at least 1 inch of its trunk. =Traumatic epilepsy.= When epilepsy arises after a head-injury, it is almost the invariable rule that the attacks should partake _at first_ of the focal or Jacksonian type. A case of traumatic epilepsy should, therefore, possess the following characteristics:-- 1. The fit should be preceded by some sensory or motor aura--the aura corresponding to the region of the brain primarily involved. 2. The fit should always start by twitchings of the parts supplied by the motor area which is in direct relation, or in close proximity, to the site of dural or osseous lesion.