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• W2129251795 abstract "The evaluation of structural changes of the brain and its coverings resulting in disability, following head injuries, may be greatly improved by roentgenography of the skull, encephalography, and ventriculography. Clinically, it is often difficult or impossible to evaluate the respective parts played by post-traumatic organic brain disease, post-traumatic neuroses, and unrelated abnormalities. Even when post-traumatic organic changes can be established clinically, the type and extent of the lesion often cannot be accurately determined. Roentgenographic examination of the skull, encephalography, and ventriculography may reveal structural changes which indicate the need of surgery, which make prognostic evaluation more accurate, or which establish or help to establish a basis for disability due to head injury. Fracture The simple linear fracture of the skull in itself usually means nothing as regards disability. Few cases subsequently show encephalographic evidence of cerebral damage. Of far greater significance is the fracture which crosses or courses along vascular channels, particularly the middle meningeal vascular groove, for there is apt to be a tear in the vessel with the production of an epidural hemorrhage. When the fracture line enters a mastoid, a paranasal sinus, or the nasal passage, the prognostic significance is more grave, for in these cases osteomyelitis, meningitis, meningo-encephalitis, and brain abscess are not uncommon sequelae. When the fracture line passes through channels of exit of nerves, disability due to nerve injury may follow. The comminuted fracture, which is common in the vault and infrequent in the base, is often the tell-tale evidence of underlying cerebral damage. In depressed fractures, which involve the vault in the great majority of cases, the amount of depression of the inner plate should be measured on tangential films. If this is 5 mm. or more, there is probable pressure on the brain, which should be relieved, for thereby a decrease in the sequelae may be expected. Dyke (1) believed that the earlier such treatment is carried out, the less danger there is of permanent injury to the brain, and the less likely the patient is to have convulsions at a later date. Compound fractures may be diagnosed by the presence of foreign material in the defect or internal to it or by the presence of air within the cranial cavity, indicating a more serious prognosis. There is one point which will bear repetition and should be stressed, namely, whether or not a prompt roentgenographic examination should be carried out in all head injuries. Patients who are in shock are not fit subjects to be moved about on a roentgen-ray table, for it is not the fracture itself which is of importance but the damage to the brain and intracranial blood vessels." @default.
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• W2129251795 date "1943-07-01" @default.
• W2129251795 modified "2023-09-25" @default.
• W2129251795 title "Correlation of Disability with Roentgen Findings Head Injuries" @default.
• W2129251795 doi "https://doi.org/10.1148/41.1.1" @default.
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