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William J. German

and adjacent falx was sutured over the defect. Small muscle grafts were inserted beneath the anterior and posterior edges of the dural flap, to fill the olfactory groove. The right olfactory nerve had been completely destroyed by the original trauma. Sulfapyridine medication was continued for five days after operation. Convalescence was uneventful except for the late appearance of sterile fluid at the site of the anterior-medial burr hole of the bone flap. Cerebrospinal rhinorrhea has not recurred. Case 3 . (N.H.H. #B11169). A 30 year old motorcycle policeman was

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The Lucite Calvarium—A Method for Direct Observation of the Brain

I. The Surgical and Lucite Processing Techniques

C. Hunter Shelden, Robert H. Pudenz, Joseph S. Restarski and Winchell McK. Craig

to study the cerebral circulation with a microscope. The disadvantage of this type of lucite window is its small size, namely, a diameter of either 12 or 16 millimeters. Interest in the direct observation of intracranial phenomena resulting from head trauma led to the attempt to develop a cranial window of large enough size to permit visualization of both cerebral hemispheres simultaneously. Efforts directed toward this end resulted in the development of the lucite calvarium described herein. The term “calvarium” is used to distinguish this window from those

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The Use of Products Prepared from Human Fibrinogen and Human Thrombin in Neurosurgery

Fibrin Foams as Hemostatic Agents; Fibrin Films in Repair of Dural Defects and in Prevention of Meningocerebral Adhesions

Franc D. Ingraham and Orville T. Bailey

obliterated. There was also a very slight proliferation of connective tissue about the bits of foam. At the end of three weeks, no fragments of foam could be identified. When pieces of fibrin foam had been introduced directly into the substance of cerebral cortex, the implanted material disappeared at least as rapidly as when placed on the meninges and possibly somewhat more rapidly. The small amount of gliosis, which was the only trace of the former presence of the foam, did not appear to be in excess of that which might be accounted for by the trauma of the operative

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W. M. Craig

associated destruction or trauma to the contiguous structures, such as the muscles, the long bones and the joints. Every traumatized extremity should be treated as a unit and the peripheral nerves should be carefully considered from the standpoint of a functional return. Disabilities resulting from injuries to the radial, median and ulnar nerves, as well as sciatic, tibial and peroneal nerves should be analyzed, and any treatment instituted should include every means to insure a good functional final result. The activation of denervated muscles by passive or active motion

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

be analyzed by experimental methods. When so studied each of the clinical manifestations yields valuable evidence as to its pathogenesis. Tetanic Phenomena . When any animal is struck on the head by a blow of sufficient force to cause immediate unconsciousness, many observers have noted that there is an immediate generalized muscular spasm which Duret 7 has spoken of as the tetanic stage of concussion. Miles 17 has observed tetanic or convulsive phenomena upon cerebral trauma to the rabbit, pig and cock. In the carnivora and the primates such tetanic phenomena

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Colonel C. G. de Gutiérrez-Mahoney

pronated and flexed, and the hand and fingers powerfully flexed. The same reflex movement has been observed immediately after gunshot wounds of large nerve trunks of the arm and has been so forceful as to have remained etched in the memory of the subject. The vividness of the phantom has been explained by Foerster 2 as due to a cortical engraving which was made by the strength of the impulses originating at the time of the amputation or trauma. This engraving then is more readily receptive to subsequent unorganized peripheral stimuli and is prepared to interpret them as

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Rabbit Murray A. Falconer Dorothy S. Russell May 1944 1 3 182 189 10.3171/jns.1944.1.3.0182 The Mechanics of Trauma with Special Reference to Herniation of Cerebral Tissue A. H. S. Holbourn May 1944 1 3 190 200 10.3171/jns.1944.1.3.0190 A Review of the Florey and Cairns Report on the Use of Penicillin in War Wounds May 1944 1 3 201 210 10.3171/jns.1944.1.3.0201 Intracranial Dural Cyst Captain Webb Haymaker Captain Miles E. Foster Jr. May 1944 1 3 211 218 10.3171/jns.1944.1.3.0211 Sutureless Reunion of Severed

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A. H. S. Holbourn

T he general theory of trauma will be developed in this paper by means of the theory of elasticity. Once the theories of trauma and intracranial mechanics have been put on a firm basis, it is possible to discuss particular examples of traumatic intracranial tissue damage, and to compare the theoretical predictions with the observed facts, thereby testing the general theory. The experimental investigation of herniation of cerebral tissue through a defect in the skull, reported in the preceding paper by Falconer and Russell, is an excellent subject on which to

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Jurgen Ruesch

of head injury which is not expressed in massive tissue destruction. Nevertheless, the slower apperception of the acute cases must somehow be related to the injury. As mentioned above, age and intelligence are determining factors in tachistoscopic examinations. Both progressing age and decline of intellectual functions are associated with decline of brain weight. Similarly clinical evidence points to the frequent occurrence of cerebral atrophy following head trauma in absence of any neurological signs. Therefore, it is possible that the delayed apperception after

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J. Grafton Love

of root type, and these patients require special methods of examination before accurate diagnosis can be made. If diagnostic errors are to be kept at a minimum, and if the best results are to be obtained from therapeutic efforts, the mistake should not be made of considering every intractable low back and sciatic pain as being due to protruded intervertebral disk. It should be remembered constantly that trauma may initiate the symptoms of intraspinal neoplasm just as well as those of protruded intervertebral disk. It is extremely important, in planning and