[Management strategy in severe craniocerebral trauma in a general surgical department]

Emergency treatment of severe head injury combined with multiple trauma in most cases must be performed in regional hospitals and in general surgical units. Especially in acute intracranial hemorrhage (epidural hematoma) with the urgent indication to craniotomy the transmission of the patient in a special neurosurgical department is not possible in an adequate time. Therefore general surgeons should be trained in emergency trepanation of the skull and in basic treatment of severe head injury including measuring of intracranial pressure. The tactics of treatment of severe cranio-cerebral trauma is demonstrated on 46 cases out of 869 patients with head injury treated in our hospital from 1981 to 1984.