Epidemiology, prevention and countermeasures against severe traumatic brain injury in Japan and abroad.

On the basis of accurate statistical reports in regard to traffic accidents and safety in Japan, it is clear that traffic accidents on the road, injured victims and all other losses due to these accidents have been increasing since around 1980. Nevertheless, the number of deaths due to traffic accidents has been gradually declining over the last six years. More detailed analysis of data revealed that the most significant factor for the recent reduction of traffic accident deaths was the marked reduction of deaths related to head injury. From the neurosurgical viewpont, the Japanese Data Bank Committee for Traumatic Brain Injury began its formal activity in 1998. Although the registered number of severe head injuries is statistically too small at present to arrive at conclusions, some interesting points draw our attention. As for intracranial pathology diagnosed by the image of cranial CT scans, two thirds of nontraffic cases have focal brain lesions alone. On the other hand, in traffic cases one third of patients have focal lesions alone and one fourth have diffuse brain lesion exclusively. In this study, in 23% of traffic accidents and 12% of nontraffic accidents, consumption of alcohol led indirectly to head injuries. The schedule and details of countermeasures taken against traffic accidents are discussed from an international viewpoint.