Traumatic injuries of the brain and its membranes : with a special study of pistol-shot wounds of the head in their medico-legal and surgical relations.

  • Phelps, Charles, 1834-1913.
Date:
1897
Catalogue details

Licence: Public Domain Mark

Credit: Traumatic injuries of the brain and its membranes : with a special study of pistol-shot wounds of the head in their medico-legal and surgical relations. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    be relieved, as is suggested by the history and post-mor- tem appearances of another of the tabulated cases. Certain cases in which respiration was equally retarded, and in which opportunity for necropsic confirmation was wanting, have not been described. Cyanosis and pulmonary oedema, which occurred in but five instances, including the two in which hemorrhage did not extend beyond the pons, are independent of the gan- glionic disturbance. These symptoms in this relation are to be ascribed to compression of the intracranial portion of the pneumogastric nerve. Irregularities of respiratory rhythm, which are occa- sionally noted in cases of hemorrhage, are due to concom- itant cerebral lesion. The disturbance or abrogation of muscular function was an occasional symptom, and was exhibited in accord- ance with established laws of cerebral localization. Paral- ysis occurred in three of the fatal cases and in two of those which recovered after operation; it was hemiplegic in four and paraplegic in one. Muscular rigidity, affecting one side or both, occurred in six cases; and general con- vulsions in three, in one of which the paroxysms preceded injury; simple twitching of the muscles characterized three others. In each case some part of a motor area was covered by the hemorrhage, which was variously epidural, pial, or cortical, and acted as a paralyzing or an irritant le- sion, according to its extent and situation. These motor disturbances, while of great positive diagnostic import- ance, are so frequently absent that they have no corre- sponding negative value. In a single case in which there was protrusion of both eyes as well as dilatation of the pu- pils, there was found an epidural clot in the right inferior