Experiences of war surgery since World War 1, especially in World War II, in Germany by W. Tbnnis, in Korea, Vietnam and Lebanon have proved that penetrating brain injuries require immediate definite operation by teams of experienced neurosurgical surgeons and nurses. Modern diagnosis by computer tomography immediately reveals every type and form of primary and secondary closed and compound injuries and excludes misinterpretations, additionally present-day neurosurgical technique has improved the prognosis of every type of head injuries. Adequate training of surgeons in up-to-date neurotraumatology is absolutely essential if optimal neurotraumatological care is to be provided in case of large scale catastrophe. © 1979 Springer-Verlag.