Neurosurgical trauma in People's Republic of China

An epidemiological investigation for neurological disorders was conducted in the People's Republic of China in 1983 and 1985. The incidence of traumatic neurological injury was 55.4 patients per 100,000 population in the six big cities and 64.1 patients in the 21 rural areas. The mortality rates were 6.3 per 100,000 population (male:female = 1.7:1.0) in the six cities and 9.7 (m:f = 2.5:1) in the rural areas. In the cities, the causes of brain injury were vehicle accidents (31.7%), followed by assaults (23.8%), falls (21.8%), stumbles (15.4%), and others. Brain concussion was 68.4%, contusion was 26.0%, and intracranial hematoma was 5.6%. The incidence of spinal cord injury was 0.67 per 100,000 population in Beijing and 1.37 in Shanghai. Male versus female ratio was 7 to 1 and the peak incidence was found in ages from 20 to 30 years old. In the past decade, vehicle accidents increased along with the increasing number of cars and motor bicycles. As a result of a series of administrative measures, such as improvement of traffic control and safe-driving education, mean mortality decreased from 33.4 per 10,000 motor vehicles in 1990 to 22.0 in 1995. It has been estimated that approximately 50,000 to 60,000 people die from vehicle accidents per year. Among these cases, brain injury accounts for 39% to 57% and spinal cord injury about 10%. Since vehicle accidents are the most common cause for neurotraumatic death, an effort is needed to prevent and to decrease the incidence of these accidental traumatic injuries.