[Urgent acute situations for the general surgery department: craniocerebral trauma]

In the management of accident patients a physician must be able to recognize the life-threatening complications of craniocerebral trauma. Therefore, he must be well versed in the symptomatology of such complications and by a short neurological examination be able to find out the risk to the patient. Only in this way is it possible to decide whether the patient has to be merely observed or additional neuroradiological investigation is necessary, whether he has to be transferred to a neurosurgical department or in emergency cases be operated on immediately. In acute epidural hematoma, e.g., with signs of midbrain compression, an instantaneous trephination is imperative; therefore, a general surgeon, too, should have the ability to perform such an operation, the technique of which is described in the paper.