The impact of neurotrauma on society: an international perspective.

Neurotrauma, in many countries and particularly in the younger age group kills more people than AIDS or cancer but unlike these diseases the causes are known and it is preventable. The costs to communities in terms of suffering and economics are enormous. The common causes are road traffic accidents, falls and violence. Neurotrauma affects particularly the developing world where it consumes already over stretched health resources. In the developed world steps to reduce the incidence of neurotrauma and to treat the victims have had some effect nevertheless it stills remains an endemic problem which does not receive the public awareness or the political support it deserves. For the victims there is general agreement on the principles of clinical management but often difficulties in applying early and effective care in countries with the greatest need because of shortage of facilities and expertise. To reduce the overall burden of neurotrauma demands actions which extend from the political to basic patient care. There have been remarkable advances in the understanding of acute brain and spinal cord injury and encouraging possibilities for effective neuroprotection, repair and regeneration but in the broader context prevention of neurotrauma is the urgent imperative. In this endeavour the neuroscientist has knowledge which informs and encourages policy makers to take the steps necessary to reduce injury. These steps require political will and community support for hard decisions which impact on the way people conduct their daily lives. The WHO predicts that unless there are changes in present policies and if there are no additional road safety countermeasures put in place, there will be a major increase in road traffic fatalities over the next 20 years and beyond (World Health Organisation. (2004). www.who.int).