[Principles and priorities of therapy of polytraumas in neurosurgery]

In polytrauma cranio-cerebral injuries are the most frequent and severe lesions. Acute haematomas and other space-occupying processes demand immediate treatment. The simultaneous operation of extracranial haematomas and haematomas of the abdomen etc. with the same priority is obligatory. The diagnostic possibilities have been discussed. Indication and time of operation of other cranio-cerebral as well as of extracranial injuries, fractures etc. are decisively influenced by the grade of hypothalamus and brain stem involvement. The present possibilities to diagnose and measure those lesions have been discussed, among them the CT-findings and the clinical signs in the different stages of polytrauma. Three cases have been cited to stress the necessity of a permanent coordinated diagnostic and therapeutic procedure.