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A. Earl Walker, Jerry J. Kollros and Theodore J. Case

for 300 mm. of mercury. (The abbreviations are as follows: RO, right occipital cannula; LP, left parietal cannula; RF, right frontal cannula.) (Time is indicated in tenths of a second on the baseline.) Holbourn 12 states that linear acceleration of the brain producing waves of compression and rarefaction causes little or no damage and that shearing forces produced by rotational acceleration are the main cause of brain injury. Such being the case the pressure waves which have been demonstrated might not play so great a role as those shearing strains

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* No. Fr. of skull Gunshot Wounds Penetrating brain injuries (72 hours or older).................... 23 23 Non-penetrating (dura intact):  Treated with penicillin.......................................... 17 11  Treated with sulphonamides alone.............................. 10 3 Head Wounds due to Blunt Injury  Treated with penicillin.......................................... 16 —  Treated with sulphonamides alone.............................. 7 2   Total

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Jurgen Ruesch

. 14 The influence of psychological factors in the testing of visual fields is stressed by Gelb and Goldstein. 4 These authors attribute the occurrence of ring scotomata and concentric restricted fields to fatigue following brain injury. Halstead 8 reported on the dynamic visual field, that is, that portion of the peripheral retinal field that can be made to yield the threshold visual impression at the same instant that a form discrimination is being made in the region of the fovea. He found that campimetric and dynamic fields coincide in lesions of the occipital

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Histologic Studies of the Brain Following Head Trauma

IV. Late Changes: Atrophic Sclerosis of the White Matter

Joseph P. Evans and I. Mark Scheinker

included duodenal ulcer with massive hemorrhage, generalized vascular sclerosis, and recent skull fracture of the right temporo-parietal region with focal extradural hemorrhage and evidence of old extensive brain injury. Gross Anatomic Changes . In the right posterior parietal region there was a thin intradural clot, 3 cm. in width and 8 cm. in length. The brain itself showed old brown staining over the dorsal surfaces of the frontal poles, and at the tip of the left frontal pole an old area of contusion, measuring 1.5 cm. in diameter. In the very tip of the right

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Charles Brenner, Arnold P. Friedman, H. Houston Merritt and D. E. Denny-Brown

laboratory procedures were done when possible during the hospital stay and on some patients in the course of the follow-up. Whenever possible, the following factors concerning the patient were especially noted: type of accident, location of any scalp or skull injury, and extent and location of any brain injury. During the hospital course the following things were ascertained about the headache: its location, type, mode of onset, when first experienced, effect of posture, sleep, mental and physical effort, and lumbar puncture. The associated symptoms and signs were noted

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R. A. Groat, W. F. Windle and H. W. Magoun

and its equivalents has produced much confusion in the realm of traumatic brain injuries and their sequelae. We hope the present study will help form a basis for limiting its use. SUMMARY Concussions of the brain were induced in rhesus monkeys by striking the head with a pendulum apparatus, by dropping a weight on the piston of an hydraulic apparatus connecting with the interior of the cranium by means of a metal cannula, or by striking with a hammer a Wood's metal life-cast applied to the head. In acute physiologic experiments, it was demonstrated that

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Arnold P. Friedman, Charles Brenner and D. Denny-Brown

possible during the hospital stay and whenever necessary in the course of the follow-up. The following factors concerning each patient were especially noted—locations of any scalp or skull injury, signs of brain injury, any bleeding from the ears, deafness, disorders of the drums, and any previous history of vertigo or aural disease. The patient was questioned as to when the vertigo was first experienced, whether there was any definite sense of motion, whether he felt that objects were moving or whether he was, the effects of posture, effort, both physical and mental

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Robert S. Dow, George Ulett and John Raaf

, (2) semicoma, (3) mild, moderate, or severe confusion. In defining these terms we followed the usage outlined by the Medical Research Council Brain Injuries Committee of Great Britain. * As a control, records were taken during the course of the study on 211 persons who were considered “normal” subjects. There were 171 men and 40 women in the control series; their age range was 16 to 77 years, the mean age being 34.3 years. In order to evaluate the factor of old cerebral trauma, both the control subjects and the patients with head injuries were asked whether

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Histologic Studies of the Brain Following Head Trauma

I. Post-traumatic Cerebral Swelling and Edema

Joseph P. Evans and I. Mark Scheinker

the two conditions, which are characterized by an increase in brain volume, some convolutional flattening, and by increased volume of the white substance which results in narrowing and compression of the gray matter. In addition the ventricles are apt to be compressed, and, in unilateral swelling or edema, to be shifted. The differentiation between the two conditions is made histologically, and the criteria of recognition, as already specified by one of us in cases of brain tumor, 10, 11, 12, 13 have been found in this study to apply in instances of brain injury

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Arthur D. Ecker

was no evidence of skull fracture in either case. It is, therefore, suggested that impairment of cerebral arterial circulation may be a significant factor in traumatic dilatation of the cerebral ventricle. Neurosurgeons have recognized for some time the high frequency of death in cases of hemorrhage from the middle meningeal artery. It has been reasonable to suppose that death was due not to the hemorrhage itself but to the associated brain injury. In Case 4 an unsuspected lesion, ischemic necrosis of the internal carotid artery, was discovered at necropsy. In