The Surgery of the Skull and Brain
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THE SURGERY OF THE SKULL AND BRAIN
PREFACE
CONTENTS
LIST OF ILLUSTRATIONS
CHAPTER I CRANIO-CEREBRAL TOPOGRAPHY
The superior longitudinal sinus.
The lateral sinus.
The infratentorial region.
The supratentorial region.
(a) The external angular frontal process.
(b) The malar tubercle.
(c) The temporal crest.
(d) The parietal prominence.
(e) The zygoma.
The middle meningeal artery.
The lower limit of the cerebrum.
The Sylvian point and fissure.
The fissure of Rolando.
The parieto-occipital and first temporo-sphenoidal fissures.
The cortical motor and sensory areas.
CHAPTER II THE SPECIAL TECHNIQUE IN OPERATIONS ON THE SKULL AND BRAIN
Preparatory treatment.
Precautions against the development of shock.
The anæsthetic.
The position of the patient.
Preparation of the operative field.
THE CONTROL OF HÆMORRHAGE
Hæmorrhage from vessels of the scalp.
Hæmorrhage from the bone.
Hæmorrhage from the dural vessels.
Hæmorrhage from the superficial vessels of the brain.
THE OPENING OF THE SKULL
Craniectomy.
Craniotomy.
Opening the dura mater.
Sewing up the dura mater.
Replacement of the osteoplastic flap and sewing up.
After-treatment.
CHAPTER III CEPHALOCELES. BIRTH-HÆMORRHAGES. BIRTH-FRACTURES. DERMOIDS. HYDROCEPHALUS
CEPHALOCELES
Congenital cephaloceles.
Position of the tumour.
Size, structure, and contents.
Treatment.
TRAUMATIC CEPHALOCELES
Symptoms.
Treatment.
Fractures of the skull resulting from injuries received at or shortly after birth.
FRACTURES OF THE VAULT
(a) Depressed fractures.
(b) Fissured fractures.
BIRTH-HÆMORRHAGES
Extracranial hæmorrhages.
Treatment.
Intracranial birth-hæmorrhages.
Symptoms.
Treatment.
DERMOIDS
Treatment.
HYDROCEPHALUS
Congenital internal hydrocephalus.
Acquired hydrocephalus.
Progress of the case.
Treatment.
Operation.
Ventricular-subdural drainage.
Ventriculo-abdominal drainage.
CHAPTER IV FRACTURES OF THE SKULL
General considerations.
FRACTURES OF THE BASE OF THE SKULL
(a) Aran’s theory of irradiation.
(b) The bursting and compression theories.
(c) The contre-coup theories.
Summary of theories.
The influence of sutures on the line of the fracture.
The influence of air-sinuses, &c., on the line of the fracture.
The influence of basic foramina.
The probable line of basic fracture in any given case.
Summary.
SYMPTOMS RESULTING FROM FRACTURE OF THE BASE OF THE SKULL
Symptoms pointing to fracture of the Anterior Fossa.
SYMPTOMS POINTING TO FRACTURE OF THE MIDDLE FOSSA
External hæmorrhages.
Escape of cerebro-spinal fluid.
Escape of brain-matter.
Involvement of nerves.
SYMPTOMS POINTING TO FRACTURE OF THE POSTERIOR FOSSA
External hæmorrhages.
Escape of cerebro-spinal fluid.
Escape of brain-matter.
Involvement of nerves.
FRACTURE OF THE MASTOID PORTION OF THE TEMPORAL BONE
Surgical emphysema and pneumatocele.
Bleeding from the ear.
Treatment.
FRACTURES OF THE VAULT OF THE SKULL
Fractures of the external table alone.
Fractures of the internal table alone.
Fractures involving the whole thickness of the skull.
Symptoms associated with fracture of the vault.
Evidence supplied by local examination.
The temperature in its relation to head-injuries.
Treatment of Fracture of the Base of the Skull.
TREATMENT OF FRACTURES OF THE VAULT OF THE SKULL
Indications for operation.
Treatment.
The operative treatment of fractures of the vault.
Fissured fractures.
Depressed fractures.
Punctured fractures.
Fractures limited to the external table.
Fractures limited to the internal table.
THE MORTALITY FROM FRACTURE OF THE SKULL
CHAPTER V INTRACRANIAL INJURIES: EXTRA- AND SUB-DURAL HÆMORRHAGES. INJURY TO THE BRAIN
HÆMORRHAGES
I. Extra-dural hæmorrhage.
II. Subdural hæmorrhage.
INJURY TO THE BRAIN
Symptoms.
Points in the differential diagnosis between traumatic and other forms of coma.
CHAPTER VI THE REMOTE EFFECTS OF HEAD-INJURY
General considerations.
The effect of age.
The effect of disposition.
The effect of status.
Traumatic neurasthenia.
Treatment.
Traumatic cephalalgia.
Treatment.
Traumatic epilepsy.
The localizing symptoms of traumatic epilepsy.
Pathology.
The clinical course of the case.
Operation.
Traumatic insanity.
Treatment.
MENINGEAL CYSTS
Cysts within the calvarium.
TRAUMATIC ORBITAL ANEURYSM (Pulsating Exophthalmos)
Symptomatology.
Treatment.
CHAPTER VII TUMOURS OF THE BRAIN
Tumours of the brain.
Pathology.
Symptomatology.
Lumbar puncture.
X-ray examination.
Treatment.
CHAPTER VIII THE INFECTIVE DISEASES OF THE BRAIN AND MENINGES: ABSCESS OF THE BRAIN, MENINGITIS, LATERAL AND CAVERNOUS SINUS THROMBOSIS, HERNIA CEREBRI
ABSCESS OF THE BRAIN
Multiple abscess.
Acute traumatic abscess.
Chronic abscess.
MENINGITIS
Serous meningitis.
Pachymeningitis externa.
Pachymeningitis interna and pachymeningitis interna hæmorrhagica.
Acute lepto-meningitis.
Some anatomical considerations of meningitis.
Symptomatology.
Treatment.
SINUS THROMBOSIS
Lateral sinus thrombosis.
Cavernous sinus thrombosis.
HERNIA CEREBRI
Treatment.
CHAPTER IX BULLET-WOUNDS OF THE SKULL AND BRAIN
Injury to the bone.
Fractures limited to the external table.
Fractures limited to the internal table.
Gutter fractures.
The complete fractures produced by penetrating and perforating wounds.
Injury to the brain.
Symptomatology.
Indications for operation.
Operation.
Complications.
Results.
CHAPTER X TRIGEMINAL NEURALGIA
NEURALGIA MINOR
Treatment.
NEURALGIA MAJOR
Symptomatology.
Treatment.
CHAPTER XI TUMOURS OF THE SKULL-BONES
Tumours of the skull-bones.
OSTEOMATA
SARCOMATA, PRIMARY AND TRAUMATIC
INDEX
Transcriber’s Notes
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