Present status of neurosurgical trauma in Germany.

Exact epidemiological data on head injury in Germany are limited and based on data from death certificates, the Federal Board of Statistics (Bundesamt für Statistik), small regional cohort studies, and health insurance. With a population of 82 million people there had been 279,029 head injuries admitted to hospital in Germany in 1996. The majority had the diagnosis. "concussion," which refers to completely reversible lesions. Head injury caused the deaths of 9415 patients in 1996, which amounts to a mortality of 11.5 per 100,000 inhabitants. At the same time there were 135 independent neurosurgical units, all of which had a computerized tomography scanner available. Of all fatal cases, however, 68.4% died before they reached a hospital. The exact cost is difficult to assess, because head injury causes more costs than only the hospital stay and rehabilitation.