2009 Volume 32 Issue 1 Pages 25-31
Objectives: Recently, it has misgivings about traumatic brain injury (TBI) parting of neurosurgeons. Standard guidelines for management of severe TBI were announced in 2000 by the Japan Society of Neurotraumatology. The purpose of this study was to understand the situation regarding the system of neurotrauma treatment in Japan.
Method: A questionnaire regarding management of severe TBI was sent to each specialist training medical center of the Japan Neurosurgical Society (384 facilities). Answers were obtained by mail from 233 medical centers (60.7%).
Results: Initial treatment of TBI patients was the responsibility of the Department of Neurosurgery (NS) in 34% of the medical centers, the Emergency Department (EM) in 29%, and a combination of these departments in 36%. Surgery was performed by NS in 90% and EM in 4% of facilities and postoperative management by NS in 76% and EM in 11%. The guidelines were acknowledged by 94% of the medical centers, but only 72% of the centers used a protocol that conformed to the guidelines.
Conclusion: Neurosurgeons in Japan are positively involved in management of severe TBI. Many medical centers may find it difficult to conform to the guidelines because of a lack of neurosurgeons and equipment shortages. These problems can be addressed by consolidation of neurosurgeons in a centralized center in each region and improvement of the medical insurance system for enhancement of equipment.
