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William J. German

C erebrospinal rhinorrhea is a relatively common complication of craniocerebral injuries in the frontal region, especially when the site of impact is near the glabella. † Spontaneous arrest of the rhinorrhea may be expected within ten days in a large percentage of patients, and Adson 1 has noted spontaneous recovery as long as eight weeks after the injury. The problems and methods of surgical treatment of acute cerebrospinal rhinorrhea have been discussed by Dandy, 4 Teachenor, 11 Munro, 9 Cairns 2 and Coleman. 3 Cairns' 2 report leaves no doubt

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Gilbert Horrax

the next five years there were several notable contributions. In 1901, Cushing's 3 announcement of a regulating mechanism in the vasomotor center for the control of blood pressure during cerebral compression was an epoch making event. This study was and is so important for the understanding of clinical states, operative complications, traumatic brain conditions and the like that it must be included here, although this review is primarily from the clinical standpoint. As Cushing himself stated, The fact that cerebral compression occasions a rise in blood pressure

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W. M. Craig

complications. Early treatment had been continued in the physiotherapy department but the muscles of the thigh remained atrophic and weak. The joint had twice been manipulated under anesthesia without improvement. The man's gait was slow and hesitant. He limped. He could not run. He had never tried to run. The medical officer blamed him because “he would not co-operate,” because he was disinterested, depressed and resentful. He was depressed, for after ten months the incapacity was more complete than on the day of admission. He was disinterested because, in his own words

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Abraham Kaplan

cribriform plate, 8, 13, 14 erosion into the anterior cranial fossa by an orbito-ethmoidal osteoma, 7, 10 downward extension of a pituitary neoplasm through the sphenoidal sinus, 16 and craniotomy. Meningitis is, of course, the greatly feared complication of cerebrospinal rhinorrhea and in untreated cases the mortality varies from 40 to 50 per cent. 3, 4, 11 However, with the use of sulfonamide drugs the outlook today is more favorable. Measures including rest, dependent posture, and a decrease in intracranial pressure favor the stoppage of cerebrospinal rhinorrhea

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Robert C. L. Robertson

(hair, straw, cinders, dirt, stones, etc.) occurred in five cases. In one case an osteomyelitic area of bone was removed four months before cranioplasty. Only three and a half weeks intervened between removal of a brain abscess and tantalum cranioplasty. Compounding into the frontal sinuses occurred in three instances. In these cases the mucous membranes were removed, the communication with the nose was occluded with muscle stamp, and the bone defect was repaired without complication. Also in three cases the superior rim and roof of the orbit were defective

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Frank Turnbull

T he most interesting feature of cerebellar extradural hematomata for the neurosurgeon is their rarity. The diagnostic and therapeutic problems arising from this complication of head injury have been mentioned in the literature only during the past decade, and very few case reports have been published. All of the instances of this rare syndrome that have appeared to date have dealt with cases of acute cerebellar extradural hematoma. The following case seems worthy of record as the first account of a patient who suffered from delayed symptoms. Whether it should

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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

wonder if the fluid levels seen in the subdural spaces might be blood rather than cerebrospinal fluid. In my own practice we have limited the maximum amount of fluid withdrawn at encephalography to 150 cc. in any case. Also we have felt oxygen is much more quickly absorbed than air and that its use might lessen the danger of such complications. Dr. Robert B. Aird : The type of gas employed in pneumoencephalography makes a definite difference in the incidence of subdural gas collections as reported by Drs. Erickson and Paul. Drs. Stone and Jones in 1933 made a

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

; Penfield 8 33 per cent, persisting more than six months in 28 per cent; Rowbotham 10 in 80 per cent, while Knoflach and Scholl 5 state that mild headaches occur after every head injury. Some of the discrepancies among the various investigators may be explained by the selection of the cases studied, complications following injury, variations in length of follow-up, and type of therapy used. Considerable difference of opinion exists as to which are the most important factors in the causation of post-traumatic headaches. Schaller 12 lists headache as a symptom of post

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

unrelated complications be excluded. Further, since the main objective of the inquiry was related to disability in persons in regular occupations, uncomplicated by the effect of age or difficulty in follow-up, the study was limited to age groups between 15 and 55 years and excluded chronic alcoholics and chronic unemployed. The material, selected in these respects, was fairly evenly distributed in the age group 15–54, and consisted of 125 males and 75 females of a variety of national stocks (71 predominantly Irish) and occupations (96 skilled or semi-skilled workers

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W. K. Livingston, E. W. Davis and K. E. Livingston

patients were all sailors or marines whose wounds were sustained in the Pacific theater of war. They reached our hospital on an average of three months from the time of wounding. In this interval they had received excellent care aboard ship or in the various land-based Hospital Units of the Navy, and in general their condition on reaching the mainland was excellent. The number of serious complications was remarkably low. Approximately one-third of these patients were transferred to other hospitals before our studies were completed, and a few additional have been received