Jennett B
Neurosurg Rev. 1986;9(1-2):129-33. doi: 10.1007/BF01743064.
Head injuries are major cause of death and disability under the age of 45 years even in developing countries. Mortality and morbidity are frequently due to avoidable secondary brain damage in patients whose initial injury was not very severe. Optimal care depends on neurosurgeons defining clear management policies for injuries of all severities so that other surgeons know which patients need neurosurgical care and know how to deal with the others. More patients need to go to neurosurgeons; only specialized centers dealing with many cases can develop advanced clinical skills and have the capability to carry out major clinical research. In the competitive world of high technology medicine neurosurgery needs to deliver good care for head injuries in the community as a whole if it is to attract substantial support.
即使在发展中国家，头部损伤也是45岁以下人群死亡和残疾的主要原因。死亡率和发病率往往是由于初始损伤不太严重的患者发生了可避免的继发性脑损伤。最佳治疗取决于神经外科医生为所有严重程度的损伤制定明确的管理政策，以便其他外科医生知道哪些患者需要神经外科治疗，以及如何处理其他患者。更多的患者需要转诊至神经外科医生处；只有处理大量病例的专业中心才能发展先进的临床技能，并具备开展重大临床研究的能力。在高科技医学竞争激烈的环境中，神经外科若要获得大量支持，就需要为整个社区的头部损伤患者提供良好的治疗。
