Compound depressed fracture of the skull : cerebral abscess, hernia cerebri, recovery : with a consideration of the subject of hernia cerebri based upon one hundred and nine collected cases / by R. Lawford Knaggs ; communicated by Mr. Bryant.

Knaggs, Robert Lawford.

Date:: 1897

Credit: Compound depressed fracture of the skull : cerebral abscess, hernia cerebri, recovery : with a consideration of the subject of hernia cerebri based upon one hundred and nine collected cases / by R. Lawford Knaggs ; communicated by Mr. Bryant. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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$forced, and wliicli had produced paresis of the right leg and con- vulsions. 20th.—Hernia cerebri showed itself. 25th.—Compression symptoms with increase of hernia. Htemor- rhage took place from it, and to prevent death from bleeding it was cut off close to its overlapping base, and styptics applied on lint. The tumom- quickly recurred, and evidently was septic. Slight recurrence of hEemorrhage. 28th.—Death. The tumour cut off was the size of half an orange, and consisted chiefly of blood and brain, the latter external to the former, and seemed to form the parietes of a cyst into which blood had flowed and coagulated. Post-mortem.—The parts of the brain in the vicinity of the fracture were soft, pulpy, and mixed Avith blood. Case 105. Moyle, ‘ Lond. Med. Reposit.,’ vol. viii.—Boy aged 8. 1st day. —Compound depressed fi-acture involving both parietals. Operation. Large wound of membi’anes found. Escape of brain substance. 6th.—Hernia cerebri ; convulsions. Compression failed. 11th.—Tumour removed by the knife ; the haemorrhage nearly proved fatal. 13th.—Death. Case 106. Grimston, ‘Lond. Med. Journ.,’ 1789, vol. x, p. 277. —October 13th, 1788. Boy aged 4 was trephined for compound depressed fracture of right parietal and frontal bones, when the meninges were found injured, and portions of brain protruded. A few days later a fungus appeared, and was gradually reduced by solution of blue vitriol and pressure. Progress was satisfactory till early part of December, when it reappeared, and gi-ew rapidly in spite of caustics and pressui’e, and was finally removed by ligature. February, 1789.—Left facial paresis always relieved when matter escaped from the opening in the bones. 23rd.—Vomiting. Convulsions involving left ai’m and face. The fungus, Avhich had grown as lai’ge as before, was incised, and an ounce of pus let out, but his condition continued unsatisfactory, and on March 11th further interference evacuated a large quantity of colourless fluid with some relief. March 12th.—The prominence Avas remoA’^ed, but no further fluid appeared. The tumour grew again rapidly, and would not bear pressure. Vomiting, spasmodic affections, especially a rigidity of$