[Severe trauma of neck and skull base ].

The concept of internal decapitation comprises lesions within the skull base, upper spinal column with partial or complete destruction of the cervical part of the medulla. By means of casualties due to internal decapitation we demonstrate that, besides the known causes, a rotational damage at the juncture of the upper spinal column to the skull base as well as fractures by axial stretching may cause such traumas. A decrease of such accident's consequences is hardly possible because of the amount of energy involved causing the damage. Due to a steady increase of traffic, particularly by motor-bicycle, we shall have to cope with more cases of this kind of damage.