The Australian and New Zealand journal of surgery
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Injuries of the nervous system are common, and cause many deaths and much permanent disability. They inflict an enormous financial burden on the national economy; in Australia, adequate data are at present lacking, but a simple extrapolation from Canadian statistic suggests an estimate of more than $500,000,000 annually for the injuries resulting from road traffic accidents alone; if other causes of injury are included, the figure may reach one billion dollars. The neurosurgeon is specifically trained to undertake the management of all forms of neurological trauma; however, in Australia, and in many other countries, only a small minority of such injuries receive neurosurgical care. ⋯ Many cases must therefore be in the care of general or orthopaedic surgeons, especially in country centres, and it is important that these surgeons should have some basic neurosurgical training. The Neurosurgical Society of Australasia wishes to formulate a programme to ensure that opportunities for such training are available throughout Australia. This programme should also embody a national plan for research into the treatment and prevention of neurological trauma.
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The close association of the external and internal carotid circulations in the orbital cavity is well recognized. Two cases are presented in which local trauma to the orbit apparently resulted in the formation of an arteriovenous fistula. ⋯ The investigation by selective angiograms and the surgical management of these malformations are discussed. A further case is presented in which an early lesion was noted in angiography after a head injury, with subsequent disappearance of the lesion some weeks later.