Craniectomy for microcephalus : the later history of a case of excision of the hand-centre for epilepsy : a clinical lecture delivered at the Jefferson Medical College Hospital, November 19, 1890 / by W.W. Keen.
- William Williams Keen
- Date:
- 1890
Licence: Public Domain Mark
Credit: Craniectomy for microcephalus : the later history of a case of excision of the hand-centre for epilepsy : a clinical lecture delivered at the Jefferson Medical College Hospital, November 19, 1890 / by W.W. Keen. 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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![later on the other side. The line of incision in the bone is now complete and extends to within three fourths of an inch of the supraorbital ridge and backward nearly to the occipital bone, measuring six and one-fourth inches in length and one-fourth of an inch in width. One rather large branch of the middle meningeal artery is seen crossing the cleft. The forceps are all removed and the flap is carefully inspected to see if there are any bleeding vessels. The haemorrhage is usually stopped by the forceps, but in case I find any bleeding points I will pass a stitch under them, as I wish all bleeding to be completely arrested before the wound is closed. The periosteum is next cut away from the edges of the groove so that it will not cover it and cause union of the bone. A few strands of horsehair are placed in the groove and are cut sufficiently long to prevent danger of their slipping under the scalp in this case. These hairs will all be removed, except two or three, at the end of two or three days. In sewing up the flap I am careful to get absolute coaptation, so that there shall be no overlapping, as this would expose a surface which must heal by cicatrization. The wound is care- fully dressed with sterilized gauze and she will be laid upon her right side to favor drainage. Now, gentlemen, the operation is completed, and we have only to await the future. Her mental traits have been closely observed, so that it may be readily seen whether there is any change in her intelligence. [Note.—She was entirely well and all the sutures were out in five days. The operation took an hour and convinced me that it could be done in probably one-half that time by a proper pair of rongeur forceps. These I have had made, and I will report upon their usefulness in the future.—W. W. K.]](https://iiif.wellcomecollection.org/image/b22454536_0014.jp2/full/800%2C/0/default.jpg)
