Posttraumatic cerebral contusions, lacerations and hematomas in the past could often only be suspected by clinical symptomatology and be visualized by angiography in a restricted manner, but they are now diag nosed with precision through CT and MRI; they remain in the limelight in our daily management of severe head injuries. Stalhammar's longlasting research in biomechanics is he re condensed in a concise review of the current knowledge in this field, thus providing the basis for our understanding of the parenchymal cerebral posttraumatic lesions. The neuropathological investigations and findings remain fundamental to the clinical features, and in this text there is the advantage that they were carried out and interpreted by a very experienced neurasurgeon, Ion Oprescu, who most regretfully died before the completion of this volume. The special morphological and clinical investigations by Nakamura, concerning diffuse brain injury, contribute to our necessary diagnosis and treatment of this phenomenon where, without grass visible lesions of cerebral tissue, a high mortality occurs. The clinical features, the princip1es of therapy and the outcome are described by Vigouroux and Guillermain, whose clinical study clearly demonstrates the limitations of all our efforts in severe brain injuries, in spite of decades of clinical experience and research."

The 28th annual conference of the German Society for Neurosurgery was held in Cologne, West Germany, from the 18th to the 21st of September 1977. The conference dealt with problems concerning craniocerebral injuries and space-occupying processes in the posterior cranial fossa as well as general topics on clinical practice and research with special attention paid to the work of younger neurosurgeons. This volume is a presentation of the conference results. Within the scope of the general topics, special interest was directed toward the que stion of the current status of cytostatic treatment for brain tumors. In addition to experimental investigations, the results concerning cerebral tumors and medulloblas tomas are reported. Cerebellar tumors represent two further focal points: 1. From the diagnostic viewpoint, specific results from computerized tomography are discussed, especially with regard to the more extensive anatomic difficulties involved in the posterior cranial fossa. 2. With emphasis on cerebellar processes, the results of long-term measurements of intracranial pressure during the postoperative follow-up period are reported."

The Committee of Neurotraumatology of the World Federation of Neurosurgical Societies decided to elaborate a Glossary of Neuro- traumatology, and for this purpose appointed a subgroup of members of this Committee, headed by Dr. E. S. Gurdjian, whose report follows this preface. The main reason for the Committee's decision was the hope that the diffusion of the Glossary through "Acta Neurochirurgica" may bring about a better understanding of neurotraumatological terminology on a worldwide scale. The Glossary should facilitate the classification and the comparison of traumatic lesions of the Nervous System. It will consequently be easier to compile statistics and correctly interpret the informations thus obtained. The very commendable initiative of the Congress of Neurological Surgeons in revising the terminology of head injuries and in publishing this work in Vol. 12 (1966) of "Clinical Neurosurgery" constitutes an important contribution. In 1977 the Glossary now presented endeav- ours to complete and bring up to date the definitions of anatomical or physiological modifications in the neurotraumatological field. We wish to express our thanks to Dr. Gurdjian and to the other members of the Neurotraumatological Committee who were responsible for the elaboration of this Glossary and whose efforts to standardise, as much as possible, the language used by scientists of different nationalities, have resulted in a better understanding between neurosurgeons.

Die Differenzierung und prognostische Beurteilung der Atemstorungen bei schweren Kopfverletzungen ist ein dringendes Problem geworden. Beobachtungen an Verletzten, die eine Cheyne-Stokes-Atmung oder Schnapp- atmung iiberlebt haben, Atemstorungen, die friiher als Hirnstammschadigung prognostisch vollig infaust beurteilt wurden, zeigten die Notwendigkeit, syste. matische Untersuchungen auf diesem Gebiet durchzufiihren. Die klinische Beurteilung von Atemstorungen geschah bisher im wesentlichen gestiitzt auf altere tierexperimentelle Untersuchungen. Leider fanden die spiro- metrischen Untersuchungen, die KNIPPING u. Mitarb. bereits 1930 an Patienten mit Hirntumoren und Hirndurchblutungsstorungen durchfiihrten, nicht die ent- sprechende Resonanz, obwohl sie wegweisend fiir die wissenschaftliche Arbeit der Neurologen und Neurochirurgen hatten sein konnen. Sicherlich standen die Schwierigkeiten bei der technischen Durchfiihrung hindernd im Wege. Durch die neueren BehandlungsmaBnahmen schwer Hirngeschadigter haben sich auch die Untersuchungsmoglichkeiten der Atemstorungen verbessert. So war es meinem Mitarbeiter FROWEIN moglich, bei 170 Patienten mit frischen Hirnverletzungen oder anderen Hirnschadigungen durch Geschwiilste, Durchblutungsstorungen, Anfallsleiden und postoperative Veranderungen, unter Anwendung der modernen Spirometrie und der gasanalytischen Methoden die Atemstorungen systematisch zu erfassen. Erfreulicherweise gelang es ihm, durch 370 Einzeluntersuchungen auch Verlaufe unter dem EinfluB des Krankheitsgeschehens wie der Behandlung festzuhalten. Die Untersuchungen wurden durchgefiihrt mit Unterstiitzung der Europaischen Gemeinschaft fiir Kohle und Stahl (Hohe Behorde) und des Bundesministeriums fiir Arbeit und Sozialordnung. Ganz besonderen Dank aber schulden wir unserem Kolner Physiologen MAX SCHNEIDER und seinem Mit- arbeiter HIRSCH sowie den KOllegen KNIPPING und VENRATH fiir die Beratung und Unterstiitzung, die sie Herrn FROWEIN bei der Planung und Durchfiihrung seiner Untersuchungen zuteil werden lieBen.