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Acute Head Injuries

Acute Head Injuries Abstract The patient with a closed head injury presents a different problem from the one with an obvious fracture, where the need and value of surgery are quite evident. For the patient who has a closed head injury, a decision must be made as to the opportune time for surgery or other means of treatment. Clinically, it is sometimes impossible to differentiate between a subdural hematoma and cerebral contusion with edema. Accordingly, if the patient's level of consciousness is becoming increasingly impaired or shows no improvement, the pathological neurologic signs are increasing, or the vital signs are indicative of increasing intracranial pressure, burr holes should be placed on both sides of the head. Bleeding from the cerebral vessels is usually easier to control if surgery can be delayed for 8 to 10 hours after trauma. Hence, surgery prior to that time is reserved for those patients who present a clinical picture http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives Surgery American Medical Association

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Publisher
American Medical Association
Copyright
Copyright © 1957 American Medical Association. All Rights Reserved.
ISSN
0096-6908
DOI
10.1001/archsurg.1957.01280170048028
Publisher site
See Article on Publisher Site

Abstract

Abstract The patient with a closed head injury presents a different problem from the one with an obvious fracture, where the need and value of surgery are quite evident. For the patient who has a closed head injury, a decision must be made as to the opportune time for surgery or other means of treatment. Clinically, it is sometimes impossible to differentiate between a subdural hematoma and cerebral contusion with edema. Accordingly, if the patient's level of consciousness is becoming increasingly impaired or shows no improvement, the pathological neurologic signs are increasing, or the vital signs are indicative of increasing intracranial pressure, burr holes should be placed on both sides of the head. Bleeding from the cerebral vessels is usually easier to control if surgery can be delayed for 8 to 10 hours after trauma. Hence, surgery prior to that time is reserved for those patients who present a clinical picture

Journal

A.M.A. Archives SurgeryAmerican Medical Association

Published: Nov 1, 1957

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