Catalogue of the Pathological Museum of St. George's Hospital / edited by John W. Ogle and Timothy Holmes.
- St. George's Hospital (London, England). Pathological Museum.
- Date:
- 1866
Licence: Public Domain Mark
Credit: Catalogue of the Pathological Museum of St. George's Hospital / edited by John W. Ogle and Timothy Holmes. Source: Wellcome Collection.
Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.
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![29. Fracture of the Base of the Skull, confined to the Posterior Fossse. The patient, John P., aged 40, was admitted Feb. 17th, 1829, having received a blow from a piece of timber falling on the back of his head. He had profuse bleeding from the mouth and nose, nearly perfect consciousness when spoken to, and perfect command of the muscles, excc2)t that the speech was indistinct, tie was admitted at eight o’clock, a.m., and was bled at ten, p.m., the pulse rising. The following fore- noon he somewhat suddenly became delirious, with j)owerful convulsions, and a considerable swelling made its appearance at the back of the neck and occipital region. It was not very tense ; but an incision was made down upon the bone, in order to examine the j^art, so that if any pressure existed it might be removed. The occij)ital bone was broken and de- pressed ; the fragments were so loose, and the interspaces between them so freely o})en, that the blood escaped readily, and therefore nothing further was done. The irritation produced by the heemorrhage did not last long, and at the time the incision was made, he was comatose, with stertorous breathing. He sank gradually, and died in the afternoon of the 18th. The whole surface of the brain, and the intervals between the convolutions, were covered with blood, which was in greatest quantity between the dura mater and base of the brain, esjjecially of the cere- bellum. The anterior lobe was lacerated at the base, and had blood mixed with the nervous matter. Both hemispheres of the cerebellum were deejily lacerated at their back part, so that nearly half the interior was broken into a pulp, and mixed with blood. The lateral ventricles contained a little bloody serum. The occipital bone was broken into several portions. On the right side, one piece of a somewhat triangular shape, which was moveable and partly depi’essed, was separate from the rest of the bone, the fracture extending into the foramen magnum. Op230site to this fractured edge of bone was a longitudinal rent in the dura mater, which thus communicated with the ruptured cerebellum, and the uf)f)er extremity of the rent just reached to the end of the superior lougitudiual sinus, from which the principal part of the htemorrhage, both internal and external, appeared to have come. Another line of fracture ran across the end of the right lateral sinus, whence some of the blood among the muscles of the neck might have jnoceeded; but it was not observed that the dura mater was injured at this jjart. A se^tarate line of fracture also extends from the jugular fossa in front of the right condyle of the occipital bone, partially separating it from the basilar ])ortiou. A starred fracture may also be seen in the left half of the bone, one line of which runs into the middle of the left margin of the foramen magnum. Presented by CnssAR Hawkins, Esq.](https://iiif.wellcomecollection.org/image/b24758292_0022.jp2/full/800%2C/0/default.jpg)
