New perspectives in neurotrauma research.

Traumatic brain and spinal cord injuries are severe burdens for the patients, their relatives, the health care providers and society as a whole. Recent data demonstrate the magnitude of the problem: It is mostly a disease of the young gen-eration (age 20-45 years) with mortality rates for severe traumatic brain injury (TBI) between 40-50%. In approximately 60% of cases, multiple trauma is accompanied by head injury. The outcome of TBI is determined not only by the extent and severity of the primary insult, but also by the degree of secondary brain damage. In the subgroup of severe TBI (GCS</=8) only 25%t of patients showed a complete recovery or had minor neurological deficits; 15% resulted in a lifelong disability or even in a permanent vegetative state. Economically, the impact of TBI is enormous - estimates of the costs of TBI in the U.S. range from 4-15 billion dollars per year. Valid data for Germany are not yet available.