[The contribution of the general and trauma surgeon in neurotraumatology: experiences and results of 10 years].

In acute medical service, general and traumatic surgeons are faced with the problem of treating severe head and brain injuries. In the department of surgery of the University Hospital in Munich, we have been performing neurotraumatological treatment since 1982. Within 10 years we saw 138 patients with severe head and brain injury. We had 48 cases of epidural hematoma. 81 of acute subdural hematoma. 84 of intracerebral contusional bleeding, 5 of depression fractures and 3 of hygromas. All these patients underwent surgical treatment. Osteoplastic trepanation was performed in 49 patients and osteoclastic trepanation in 60. Further interventions were elevation of the 5 depression fractures and evacuation of the 3 hygromas. Comparison with other investigations in departments of neurological surgery in the United States suggest that our results reflect a similar outcome (according to Jennet and Bond's outcome scale: 1, cured; 2, slightly handicapped; 3 severely handicapped; 4, vegetative state; 5, expired). The Traumatic Coma Data Bank (1991) 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 strategies are suggested.