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Subdural Hygroma

A Report of Seven Cases

Henry T. Wycis

, 85: 161–166. 16. McConnell , A. A. Traumatic subdural effusions. J. Neurol Psychiat. , 1941 , 4 : 237 – 256 . McConnell , A. A. Traumatic subdural effusions. J. Neurol Psychiat. , 1941, 4: 237–256. 17. McConnell , A. A. Intracranial conditions after closed head injuries. Brain , 1942 , 65 : 266 – 280 . McConnell , A. A. Intracranial conditions after closed head injuries. Brain , 1942, 65: 266–280. 18. McConnell , A. A. Prolonged post-traumatic amnesia. Findings

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Walter G. Haynes

part of a larger experience dealing with the more simple aspects of wartime neurologic surgery, such as compound, depressed skull fractures, scalp lacerations, closed head injuries, spinal cord and peripheral nerve injuries. They were all operated upon by the author, or by an assistant under the author's direct supervision. They were collected from Oran to Tunis, from Licato to Messina, Sicily and from the grim beach-head on Normandy, through France, Belgium, Holland and Germany. They were operated upon, some times under fire, in Clearing Stations, Field Hospitals

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Donald D. Matson and Julius Wolkin

foreign body ever actually reaching the surface, as large subdural hematomas have been encountered where it was impossible to find any evidence of a missile tract reaching the surface (Cases 1 and 2). When there is intracranial hemorrhage at a point distant to the wound of entrance, this blood does not escape and a space-occupying hematoma is formed. As a result, the decompression automatically obtained in the greater percentage of penetrating brain wounds is not present and the pathological physiology assumes the character of that seen in closed head injuries, where

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W. F. Windle, W. A. Rambach Jr., M. I. Robert de Ramirez De Arellano, R. A. Groat and R. F. Becker

pressure or formation occurred in the type of simple concussion with which we have been dealing. This observation is in close agreement with that of Paterson, 5 who found pressures of 180 mm. of water or less in 70 per cent of his 179 human patients in whom closed head injuries had occurred within 24 hours of the examination. Only 6 per cent of this group of patients showed pressures exceeding 250 mm. of water. The next step in our study was to produce an increase in water content of the brain equal to or greater than that which was encountered after concussion. If it

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Penetrating Craniocerebral Injuries

Evaluation of the Late Results in a Group of 200 Consecutive Penetrating Cranial War Wounds

George L. Maltby

, symptoms which are so extremely common in any large group of closed head injuries, either in civilian or military practice. 9 In 150 instances, or 75 per cent of the total series, some statement could be found as to the presence or absence and duration of unconsciousness following the acute injury. In 52 (34.7 per cent) records there was a definite statement that at no time was there any loss of consciousness. The periods of loss of consciousness were described as varying from momentary to 6 weeks. In 23 (15 per cent) instances the period of unconsciousness was less

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M. B. Bender and L. T. Furlow

patients with closed head injuries sometimes show evidence of a lesion in the spinal cord with such signs as muscular wasting and weakness, reflex changes (depressed biceps and exaggerated triceps, hyperactive knee jerks and ankle clonus) and, in addition, alteration in the intervertebral disc space. He stressed the not uncommon incidence of minor damage to the cord in association with closed head injuries. We have found two such cases, one of which is hereby described. Case 7 . W.D.Mc., an 18-year-old apprentice seaman, ran into a jackstay and struck his forehead

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Charles E. Troland, Donald H. Baxter and Richard Schatzki

always the side of the injury in both open and closed head injuries. Unilateral Enlargement of the Lateral Ventricle In 42 (29 per cent) of the 143 cases of cranial trauma there was enlargement of only one lateral ventricle. The mechanism of such enlargement is most likely direct loss of cerebral substance without diffuse cerebral change. Second-Day Encephalographic Studies In 60 cases the appearance of the ventricles was checked on the day following the encephalography. * These follow-up studies proved interesting. They showed some enlargement of the

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John A. Aita

-SIMPLIFICATION In few places in the practice of medicine does post hoc reasoning appear so frequently as it does in problems of craniocerebral injury. Once ventricular dilatation or abnormality in the EEG tracing is found, the temptation arises to impute every symptom to this. We must refer again to the instances in which no symptoms may be found (among unselected patients in particular) despite the presence of these findings. There is a great tendency to over-simplify these problems. They are sufficiently difficult to evaluate in the cases of minor closed head injury or

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W. Edward Storey and William G. Love

Unilateral paralysis of the 6th or 7th cranial nerve is encountered from time to time in disease or injury. Bilateral weakness or paralysis of the 7th nerve is seen in myasthenia gravis, in association with polyneuritis following diphtheria, in polyneuritis of the so-called infectious type as well as in alcoholic B-avitaminosis. 2 However, bilateral facial paralysis of traumatic origin is much less frequent as indicated by various reports. Among 71 cases of closed head injury, Turner 3 reports bilateral facial involvement in 1; none had associated abducent

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Arthur Ward Jr.

T he accepted treatment of severe closed head injury is largely concerned with supportive measures, 15 and no definitive therapy has been described that is directed at any specific reversal of the non-surgical pathophysiologic sequelae of trauma of the brain. Information has slowly accumulated regarding the mechanism of concussion, 3 including descriptions of the pathologic changes such as those described by Scheinker 12, 13, 14 as “vasoparesis.” Studies regarding cerebral swelling have been controversial, 11 and treatment by dehydration has now been