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September 2, 1933


JAMA. 1933;101(10):772-775. doi:10.1001/jama.1933.27430350002009

In evaluating injuries of the head, I need hardly emphasize the fact that the alterations in the skull are of relatively minor concern. Life, at least, is at stake only through the changes produced on the intracranial contents; i. e., the brain and its blood vessels. And yet textbooks still classify injuries of the head as fractures of the vault and base, as simple or compound, and as linear or depressed. This nomenclature is the heritage of a past era when the true effects of injuries of the brain were little known. Moreover, every surgical attention was directed to the skull, for, owing to sepsis, the dura was the patient's last line of defense against the attack of surgeons. A hundred years ago the accepted form of treatment of one school of surgeons, led by the illustrious Pott, was to follow every line of fracture to its terminus (when possible)

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