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Henry T. Wycis

James Paget's description of the disease in 1876. The great flattened head seemed to “mushroom” on top of the cervical spine. The veins and arteries of the temporal areas were unduly prominent. The movements of the head were limited in all directions but particularly in the lateral deviations to the shoulders. Palpation showed marked atrophy of the posterior cervical group of muscles. The spinous processes appeared thickened and prominent. The pupils were equal, but light reaction was sluggish in the right eye due to the presence of a corneal scar. The light reflex in

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Edgar F. Fincher, Bronson S. Ray, Harold J. Stewart, Edgar F. Fincher, T. C. Erickson, L. W. Paul, Franc D. Ingraham, Orville T. Bailey, Frank E. Nulsen, James W. Watts, Walter Freeman, C. G. de Gutiérrez-Mahoney, Frank Turnbull, Carl F. List, William J. German, A. Earl Walker, J. Grafton Love, Francis C. Grant, I. M. Tarlov, Thomas I. Hoen and Rupert B. Raney

of blast pressure to the brain, a bellows effect of the chest upon vascular (venous) pressure is suggested. DISCUSSION Dr. John F. Fulton : It seems to me that blast injuries of the head are closely linked not only with the problem of impact concussion but also with the various sequelae of gunshot wounds of the head with high velocity fragments. Dr. Gurdjian has reported a case in which, following a gunshot wound in the cervical spine, there was contusion of the frontal lobe. This suggests that missiles of high velocity may increase for a very brief space of

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Paul C. Bucy and Ben W. Lichtenstein

spinal nerve roots (Lichtenstein 7 ). It is found very frequently in infants suffering from extreme degrees of spina bifida (Arnold, 3 Chiari, 4 Lichtenstein, 7 Schwalbe and Gredig, 10 and Jacob 6 ). Its occurrence in adults has generally been in conjunction with bony anomalies of the craniovertebral junction, such as basilar impression, or platybasia, and fusion abnormalities of the cervical spine (Klippel-Feil's syndrome). Examples of such combinations have been reported by List 8 and by Gustafson and Oldberg. 5 The occurrence of an Arnold-Chiari deformity of

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John S. Chaffee

it difficult to do for more than 15 minutes. The importance of this detail lies in the fact that the development of many of these same muscles is essential in the successful utilization of crutches and braces in their rehabilitation program. Further, alternating the head from side to side aids in preventing stiffening of the cervical spine. The patient who is placed in the face-down position will find variation by shifting a soft pillow beneath his chest and a small pillow about his head. Eventually, however, he will find that a small pillow for his rotated

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Donald D. Matson

patient should never be evacuated, however, until the preparations outlined above have been carried out. That is, he should be lying on a “mattress” of blankets covered with a dry sheet, the heels should not be touching, an indwelling catheter should be in place and arrangements made so that it is never clamped off in transit. A small support, such as a folded towel or sheet, should be placed under the spine at the point of injury if it is in the lumbar region. If the cervical spine is involved, the shoulders should be raised 2–4 inches so as to allow the head to fall

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M. B. Bender and L. T. Furlow

patient noticed that on drying his face with a towel there was a marked tingling sensation in the fingertips of both hands. An x-ray of the cervical spine was normal. Numerous neurological examinations and all laboratory investigations were found to be negative. The shocking or vibratory sensations lasted 4½ months and disappeared completely. He has been free of this symptom during the past year. Comment . This is an example of a patient with injury to the right temporal region who showed bilateral symmetrical subjective sensory disturbance in the extremities

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Robert Slemmer

In the Naval Service where large numbers of cervical spine fractures, both with and without cord or root damage, were treated, we were faced with the problem of post-reduction immobilization. The usual methods of attaining this left much to be desired in that they were not readily adaptable or were too heavy and therefore uncomfortable for the patient. The advantages of the collar described below are that it is individualized, comfortable, and can be manipulated by the patient. In addition it is simple and inexpensive. Fig. 1 Stockinette of

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William G. Kuhn Jr.

. Celsus in the 1st Century A.D. and Aretaeus in the 2nd Century A.D. also made references to functions of the spinal cord. The earliest known reference to traumatic lesions of the spinal cord is found in the Edwin Smith surgical papyrus, 7 in which six cases of injury to the cervical spine, with the characteristic dislocation, displacement, and crushing of the vertebrae, were presented. In addition to the gross lesion of the spine itself, paralysis of all four extremities, urinary incontinence, priapism and involuntary ejaculation of semen were described. Beyond this

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J. Jay Keegan

T he clinical syndrome of nerve root compression by posterolateral herniation of a lower cervical intervertebral disc has been well presented in recent articles by Semmes and Murphey, 16 Ulmer and Meredith, 20 Spurling and Scoville, 18 Michelsen and Mixter, 13 Bucy and Chenault, 2 Elliott and Kremer, 4 Bradford and Spurling, 1 Young, 21 Eaton, 3 and Murphey and Meade. 14 It has been brought to attention by these authors that pain which extends from the lower cervical spine over the upper scapula and down the arm, often with associated numb sensation

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John A. Aita

several days or weeks, with frequent positive neurological signs persisting). Of this group with severe head injuries, only 29 per cent continued to have well-developed symptoms. One might ask, what happened to the other 71 per cent? It is this latter group we seldom see. Headaches and dizziness arise from a complex, traumatized organism. Initial study rules out intracranial infection, aneurism, bleeding and hygroma as well as injury of the cervical spine. When these are not present, one is left with causes which are multiple and vary from case to case. At present