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June 10, 1939


JAMA. 1939;112(23):2422. doi:10.1001/jama.1939.02800230046016

In 1925 Putnam and Cushing1 called attention to the striking differences between the mechanism of production and process of organization of the posttraumatic extradural hemorrhage and subsequent clot and the same factors in the subdural hematoma. The rare occurrence of subdural hematoma after skull fractures or after intracranial osteoplastic explorations, as well as its delayed reaction to trauma, suggests to them some individual predisposition of the meninges favorable to the subdural seepage of the blood. Kunkel and Dandy2 have recently stressed certain peculiarities in the pathology of subdural hematoma. The clot does not organize evenly throughout. There may be a large collection of dark fluid blood with a few soft brownish yellow clots. The fluid blood when left standing in a test tube will not clot. The outer membrane is always thick and is attached to the dura. New vascular channels from the dura connect with newly formed