NEUROTRAUMA/FOREWORD neu~trauma

Neurotrauma: Concepts, Emerging Therapies

Current Practice &

From the Department of Emergency Medicine, Wayne State University School of Medicine, Detroit, Michigan. "

Brooks F Buck, MD, FACEP Gary S Krause, MD, FACEP Blaine C White, MD Joseph Kosnik, MD, FACEP The Symposium Editorial Group, Wayne State University School of Medicine

[Bock BF, Krause GS, White BC, Kosnik J, The Symposium Editorial Group: Neurotrauma: Concepts, current practice & emerging therapies. Ann Emerg Med June 1993;22:957-958.]

The proceedings in this issue are derived from presenta- tions at the Neurotrauma: Concepts, Current Practice & Emerging Therapies symposium held in Dearborn, Michigan, June 11 and 12, 1992, and sponsored by the Department of Emergency Medicine, Wayne State University School of Medicine. The authors are world leaders in the approach of basic and clinical science to the problems of central nervous system injury, and we are very pleased that they have contributed these papers for publication in Annals.

The papers are arranged in the following sequence of subjects: comprehensive reviews of the field; studies of the pathophysiology of brain and spinal cord trauma; clinical observations and basic management strategies in blunt head trauma; experimental laboratory interventions directed at elements of the injury mechanisms; clinical evidence for a new and prolonged pharmacologic inter- vention to improve outcome after spinal cord injury and discussion of the investigational strategy required to validate such new approaches; and rehabilitation strategy following mild-to-moderate closed-head brain injury. We recognize that there is some repetition in the papers, par- ticularly issues related to mechanisms of damage, but this phenomenon represents an emerging consensus among diverse investigators. Therefore, in preparing this sympo- sium as a whole for publication, we have not attempted anywhere to reduce the attention paid to mechanisms in the individual papers; we indeed believe that this aspect of the symposium offers the reader a particularly rich view of the field.

The fact that this topic is germane to the specialty of emergency medicine is self-evident. Traumatic closed- head brain injury and spinal cord injury result in perma- nent and often severe disability for thousands of Americans yearly. It is evident from this symposium that early medical intervention in the emergency department is

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NEUROTRAUMA Bock et al

already critical to reducing the final extent of the injury and will become more so in the future. We hope that emergency physicians will read these articles thoughtfully and with care and patience, and that the insights they offer will allow our discipline to quickly incorporate the emerging new treatment modalities into the care of these patients.

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