UPTURE of the intervertebral disc in the lumbar spine most often occurs to one or the other side of the strong posterior longitudinal ligament. Rarely the central part of the ligament itself is perforated. Even more rare is the observation that the disc material has ruptured through the anterior aspect of the spinal dura and is displaced intrathecally. Only nine such cases have been reported. ~,3-7 Two patients with intradural disc herniation recently treated in the Neurosurgical Department of Ullevfil Hospital provided the stimulus for an anatomical investigation of the relation between the spinal dura and the posterior longitudinal ligament in the lower lumbar region.

Annual age-adjusted incidence rate of head injuries in Akershus County in 1974 was estimated to be 236/100,000, 307/100,000 for males and 164/100,000 for females. The highest incidence rate occurred in males in the age group 10–19 years (489/100,000) and the lowest among females in the age group 30–39 (68/100,000). In all age groups, the incidence rate was higher in males than females. This prospective study included 488 patients, of whom 88.9% had minor head injuries and 11.1% severe head injuries. 16 patients (3.3%) died due to their head trauma. Skull fracture was detected in 10.4% of the patients who survived the first 24 h, and 2.5% had operations. The mean hospital stay was 8.8 days, 10.2 days for the patients injured in traffic accidents and 7.0 days for the others. Besides having a higher incidence rate of head injuries, males suffered severe head injuries more often and their death rate was higher than head-injured females.

The negative biological, psychological and social outcomes following accidental injuries were assessed after three years in 551 adults by questionnaires, medical records and information from the National Insurance Offices. Fifty‐four percent reported at least one negative outcome. Some reduction of physical function was reported by 31.8% and worsened bodily health by 26.0%. In about half of these cases reduced life quality was the main problem. Of the persons 18.9% claimed worsened psychological health and 18.2% decreased capacity for work as an effect of the injury. It is concluded that accidental injuries are an important source of morbidity and reduced life quality in society and that the long‐term outcomes are best conceived within a biopsychosocial frame of reference.

One hundred and twelve adults admitted to a surgical ward due to accidental injuries were studied. Thirty-seven percent had a psychiatric disorder on admission (DSM-III axis I) and 21% had a personality disorder (axis 2). Substance abuse and dependence and antisocial personality disorders were most frequent. Eighteen percent were definitely distressed when injured. Persons with a personality disorder were distressed significantly more often and had sustained clinically more severe injuries. No support could be found for a hypothesis of accidental injuries being the result of hidden or unconscious self-destructive tendencies, and only one patient was injured in a suicide attempt. Defense Mechanism Test applied to a subgroup of 20 patients suggested that high perceptual defense may be related to injury occurrence in patients at fault for the accident.

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