The epidemiological aspects of the mortality, morbidity and the costs of neurotrauma in New South Wales 1977 were outlined in Part I of this report.* Part II outlines the profile of surgical work in this field in New South Wal GS in 1977. In all, 21,973 patients were admltted to New South Wales Hospitals in 1977 for neurotraumatic conditions (85% with head, 13% wlth spinal and 2% with peripheral nerve injuries); and 1,513 patients required surgery (49% with head, 22% wlth spinal and 29% with peripheral nerve injuries). The profile of surgery for disc disease Is outlined.The participation of neurosurgeons in the management of neurotrauma Is assessed.

An epidemiological study of neurotrauma in New South Wales, South Australia and the Australian Capital Territory, 1977, was initiated and sponsored by the Neurosurgical Society of Australasia, conducted by its Trauma Subcommittee In collaboration with the Division of Health Services Research, Health Commission of New South Wales, funded by the Australian Brain Foundation and the Commonwealth Department of Health and supported by the Health Commissions of New South Wales and South Australia. The following communication Is structured so as to present the esssential findings on mortality, morbidity and costs in New South Wales in 1977 in the first part and the more specific statistical profile of surgical treatment in New South Wales, 1977, in a separate, second part. The most revealing data found by this research is that cranio‐cerebral and spinal injury was the leading cause of death up to the age of 44 in New South Wales (and South Australia) and up to the age of 49 in the male population and in the country regions. It accounted for 45% of all deaths to those aged 15 to 24. Cranio‐cerebral and spinal injury caused 71% of all deaths on the roads. Sixty‐four per cent of those dying in road accidents never reached hospital. The figures for mortality and morbidity in the country regions were significantly worse than those in the metropolitan regions. The most important causes were identified and recommendations aimed at reducing this record were formulated.

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Specific progesterone and oestrogen receptor proteins were evaluated by a dextran coated charcoal assay and Scatchard plot analysis in 20 intracranial meningiomas. Eleven tumours (55%) were progesterone receptor (PR) positive (mean 108 fmol/mg cytosol protein), whilst all were oestrogen receptor (ER) negative (ER < 10 fmol/mg cytosol protein). There were no trends to suggest a relationship between epidemiological data (patient age, sex and reproductive status in females) or meningioma location and size and the receptor status of the tumour. However, of the seven meningiomas that were histologically atypical, invasive or clinically recurred within 18 months, six were PR negative (PR < 10 fmol/mg cytosol protein). These results confirm that a large proportion of intracranial meningiomas contain significant amounts of specific PR protein and suggest that PR negative meningiomas are biologically more aggressive than PR positive meningiomas. They are also consistent with the hypotheses that PR proteins are not modulated by oestrogens acting through oestrogen receptors and that there are cytokinetic differences between sex hormone receptor proteins in meningioma and breast carcinoma. The full biochemical, cytological and clinical implication of these preliminary findings will, however, require further evaluation because of the unpredictable long‐term behaviour of intracranial meningiomas.