Advances in Management of Neurosurgical Trauma : Introduction

regarding neurotrauma, statistics, emergency care service, social education, and support systems and management of head and spinal cord injuries. To decrease mortality and long-term morbidity, prevention of accidents and improvement of emergency care management are essential. Medical treatment is also essential to reduce brain edema and late neuronal cell death and to prevent the loss of vital function, especially in the brainstem and spinal cord. Although most clinical trials of newly developed neuroprotective agents have failed to improve neuronal function, the possibility that hypothermia may prevent neuronal cell death and thus reduce mortality, and that methylprednisolone may reduce damage due to spinal cord injury has been reported. The advancement of such neuroprotective therapeutic approaches is also discussed. In this special issue of World Journal of Surgery, we clarify the current status of neurotrauma including head and spinal cord injury in different countries. It is impossible to accumulate data from every country in the world, but in this issue authors describe the present status of neurotrauma and their own specific problems in each country. The exchange of such information will help to decrease accidents and mortality and to improve the outcome of patients with head and spinal cord injury.