The articles by LeCount and his associates,1 published during the decade 1915 to 1925, emphasize the frequency with which intracranial hemorrhage in its various forms is overlooked as a cause of coma, and the infrequency of uremia compared with the number of instances in which such a diagnosis is made. A correct diagnosis of intracranial hemorrhage, however, may not be of greater value than an incorrect one of uremia if the cause of the hemorrhage and the location of the extravasated blood is not determined. It is important to distinguish between an extradural hemorrhage, as in rupture of the middle meningeal artery, an encysted subdural hemorrhage, as in the cases to be described, a primary subararchnoid hemorrhage, as in rupture of an aneurysm, and a primary intracerebral hemorrhage with secondary extension to the subararchnoid space. Skilful management depends on correct differentiation of these types.
My clinical experience with chronic
HOLMES WH. CHRONIC SUBDURAL HEMORRHAGESUBDURAL HEMORRHAGIC CYST; TRAUMATIC PACHYMENINGITIS HEMORRHAGICA INTERNA; COMPRESSION TARDIVE, WITH REPORT OF CASES. Arch NeurPsych. 1928;20(1):162-170. doi:10.1001/archneurpsyc.1928.02210130165011