THE IMPORTANCE OF GENERAL AND TRAUMASURGE RY IN NEUROTRAUMATOLOGY - EXPERIENCES AND RESULTS OF 10 YEARS

In acute medical service, general and traumatic surgeons are faced wit h the problem of treating severe head and brain injuries. In the depar tment of surgery of the University Hospital in Munich, we have been pe rforming neurotraumatological treatment since 1982. Within 10 years we saw 138 patients with severe head and brain injury. We had 48 cases o f epidural hematoma. 81 of acute subdural hematoma. 84 of intracerebra l contusional bleeding, 5 of depression fractures and 3 of hygromas. A ll these patients underwent surgical treatment. Osteoplastic trepanati on was performed in 49 patients and osteoclastic trepanation in 60. Fu rther interventions were elevation of the 5 depression fractures and e vacuation of the 3 hygromas. Comparison with other investigations in d epartments of neurological surgery in the United States suggest that o ur results reflect a similar outcome (according to Jennet and Bond's o utcome scale: 1, cured; 2, slightly handicapped; 3, sevenely handicapp ed; 4, vegetative state; 5, expired). The Traumatic Coma Data Bank (19 91) recorded outcome of severe head and brain injuries as follows: 1, 27%; 2, 16%; 3, 16%; 4, 5%; 5, 36%; and our own results were: 1, 24%; 2, 17%; 3, 15%; 4, 5%; 5, 39%. Organization procedures and treatment s trategies are suggested.