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SUBDURAL TRACTION AND POSTTRAUMATIC HEADACHE: STUDY OF PATHOLOGY AND THERAPEUSIS

SUBDURAL TRACTION AND POSTTRAUMATIC HEADACHE: STUDY OF PATHOLOGY AND THERAPEUSIS Abstract One of the most frequent sequelae to injury of the head is posttraumatic headache. Sufferers from this complaint all too often wander from doctor to doctor, from clinic to clinic and, alas! from lawyer to lawyer under the unjust suspicion of being neurotic or malingering. Posttraumatic headache associated with dizziness forms a clinical entity which is described by these patients in altogether typical fashion. The patient's description of his symptoms makes the diagnosis certain and allows the understanding physician to recognize the true sufferer and to distinguish him from the neurotic patient and the malingerer. In 1927 this condition was described as a disease entity by one of us (W. P.).1 The fact that the procedure of treatment resulted in relief of symptoms in each of the reported cases was the final proof that the syndrome was a true one and that the underlying pathologic change, whatever it might References 1. Penfield, W.: Chronic Meningeal (Post-Traumatic) Headache and Its Specific Treatment by Lumbar Air Insufflation , Surg., Gynec. & Obst. 45:747, 1927. 2. Boyd, Douglas: Post-Traumatic Headache Treated by Spinal Insufflation of Air , Arch. Surg. 18:1626 ( (April) ) 1929. 3. Skinner, H.: Headache (Post-Traumatic) Relieved by Lumbar Air Insufflation , Am. J. Surg. 8:842, 1930. 4. Reichert, F.: Specific Treatment of Post-Traumatic Localized Headache by Subarachnoid Pneumotherapy , S. Clin. North America 11:1123, 1931. 5. Monrad-Krohn, G. H.: Experiences with Endolumbar Inflation of Air in Traumatic Headache , Acta psychiat. et neurol. 6:395, 1931. 6. Jessen, H.: Treatment of Traumatic Headache by Insufflation of Air , Acta psychiat. et neurol. 8:71, 1933. 7. Lewy, F.: Der Adhäsionskopfschmerz als Folge der Meningitis serosa adhaesiva circumscripta , Ztschr. f. klin. Med. 116:36, 1931. 8. Penfield. W.: A Contribution to the Mechanism of Intracranial Pain , A. Research Nerv. & Ment. Dis., Proc. 15:399, 1934. 9. An exception to this statement must be admitted. Electrical stimulation low in the temporal or the frontal lobe sometimes gives pain which is referred to the same side of the head. This is especially true near the fissure of Sylvius. 10. Penfield, W.: (a) Subdural Effusion and Internal Hydrocephalus , Am. J. Dis. Child. 26:383 ( (Oct.) ) 1923 11. The Cranial Subdural Space , Anat. Rec. 28:173, 1924. 12. In spite of the description in the original report, failure to utilize a technic necessary to keep the air out of the ventricles explains the negative results obtained with the method in some clinics. 13. We have introduced an instrument into the subdural space before closure, as already mentioned, and we have also injected air under pressure beneath the incision after the scalp was securely closed. Both of these procedures, however, may be dangerous and should never be used with the patient under general anesthesia or as a routine, since a vein connecting the brain and the sinus may thus be ruptured. Subdural hemorrhage occurred in one of our cases. The procedure should be limited to passive entrance of air while cerebrospinal fluid escapes from the lumbar puncture needle. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology & Psychiatry American Medical Association

SUBDURAL TRACTION AND POSTTRAUMATIC HEADACHE: STUDY OF PATHOLOGY AND THERAPEUSIS

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Publisher
American Medical Association
Copyright
Copyright © 1936 American Medical Association. All Rights Reserved.
ISSN
0096-6754
DOI
10.1001/archneurpsyc.1936.02260070083007
Publisher site
See Article on Publisher Site

Abstract

Abstract One of the most frequent sequelae to injury of the head is posttraumatic headache. Sufferers from this complaint all too often wander from doctor to doctor, from clinic to clinic and, alas! from lawyer to lawyer under the unjust suspicion of being neurotic or malingering. Posttraumatic headache associated with dizziness forms a clinical entity which is described by these patients in altogether typical fashion. The patient's description of his symptoms makes the diagnosis certain and allows the understanding physician to recognize the true sufferer and to distinguish him from the neurotic patient and the malingerer. In 1927 this condition was described as a disease entity by one of us (W. P.).1 The fact that the procedure of treatment resulted in relief of symptoms in each of the reported cases was the final proof that the syndrome was a true one and that the underlying pathologic change, whatever it might References 1. Penfield, W.: Chronic Meningeal (Post-Traumatic) Headache and Its Specific Treatment by Lumbar Air Insufflation , Surg., Gynec. & Obst. 45:747, 1927. 2. Boyd, Douglas: Post-Traumatic Headache Treated by Spinal Insufflation of Air , Arch. Surg. 18:1626 ( (April) ) 1929. 3. Skinner, H.: Headache (Post-Traumatic) Relieved by Lumbar Air Insufflation , Am. J. Surg. 8:842, 1930. 4. Reichert, F.: Specific Treatment of Post-Traumatic Localized Headache by Subarachnoid Pneumotherapy , S. Clin. North America 11:1123, 1931. 5. Monrad-Krohn, G. H.: Experiences with Endolumbar Inflation of Air in Traumatic Headache , Acta psychiat. et neurol. 6:395, 1931. 6. Jessen, H.: Treatment of Traumatic Headache by Insufflation of Air , Acta psychiat. et neurol. 8:71, 1933. 7. Lewy, F.: Der Adhäsionskopfschmerz als Folge der Meningitis serosa adhaesiva circumscripta , Ztschr. f. klin. Med. 116:36, 1931. 8. Penfield. W.: A Contribution to the Mechanism of Intracranial Pain , A. Research Nerv. & Ment. Dis., Proc. 15:399, 1934. 9. An exception to this statement must be admitted. Electrical stimulation low in the temporal or the frontal lobe sometimes gives pain which is referred to the same side of the head. This is especially true near the fissure of Sylvius. 10. Penfield, W.: (a) Subdural Effusion and Internal Hydrocephalus , Am. J. Dis. Child. 26:383 ( (Oct.) ) 1923 11. The Cranial Subdural Space , Anat. Rec. 28:173, 1924. 12. In spite of the description in the original report, failure to utilize a technic necessary to keep the air out of the ventricles explains the negative results obtained with the method in some clinics. 13. We have introduced an instrument into the subdural space before closure, as already mentioned, and we have also injected air under pressure beneath the incision after the scalp was securely closed. Both of these procedures, however, may be dangerous and should never be used with the patient under general anesthesia or as a routine, since a vein connecting the brain and the sinus may thus be ruptured. Subdural hemorrhage occurred in one of our cases. The procedure should be limited to passive entrance of air while cerebrospinal fluid escapes from the lumbar puncture needle.

Journal

Archives of Neurology & PsychiatryAmerican Medical Association

Published: Jul 1, 1936

References