Advances in management of neurosurgical trauma in different continents

Neurotrauma is a major public health problem. The incidence varies from 67 to 317 per 100,000 and mortality rates are in the range of near 1% for mino r injury, 18% for mild injury, and 48% for severe head injury. It is the ma in cause of death and disability in people under 40 years old. Several prob lems appear when outcome measurements, rehabilitation programs and treatmen t options are considered: In order to solve these problems a worldwide camp aign is outlined. It focuses on epidemiology, prevention, education, treatm ent, rehabilitation, social reinsertion, and outcome measurements. The goal s of such a program are to take into account realities in both developed an d developing countries, to develop worldwide acceptable programs and guidel ines, and to test those guidelines and programs and diminish mortality and morbidity, improving quality of life. We describe the concept of Centers of Excellence and an educational program, Advanced Brain Life Support. Such a program is a moral obligation because mortality and morbidity tend to decr ease in Centers of Excellence.