Der Unfallchirurg
-
Review Comparative Study
[Multiple trauma with craniocerebral trauma. Early definitive surgical management of long bone fractures?].
Head injuries are found in 17.6% of all trauma in-patients and are the most common cause of death after injury (26.6%) in Germany. Main factors for the initial and follow up assessment are the Glasgow Coma Scale (GCS) and pupil reaction. These are of a very predictive value for the outcome and are essential for the emergency crew to choose the adequat trauma hospital. ⋯ Their difference determines the cerebral perfusion pressure which should be 60 mmHg at least. Intracranial pressure rates below 20 mmHg are favourable. Optimal management within the first days is essential for good outcome.