Hemorrhage from the middle meningeal artery is relatively uncommon as a complication of head injury, but, because of the large number of head injuries that occur, this lesion is encountered fairly often. When a patient with such a condition reaches a well-equipped neurosurgical center without delay, conditions are optimum for its recognition and treatment. Many patients, however, are necessarily admitted to hospitals having few if any neurosurgical facilities, and any procedure by which cerebral compression may be kept from increasing can well be lifesaving. In such a situation a general surgeon with standard equipment may ligate the external carotid artery on the side of the suspected hemorrhage, a measure that enables the patient to be maintained in status quo until adequate neurosurgical treatment can be instituted.
Therapeutic trepanation of the skull for relief of hemorrhage after head injury actually is an ancient procedure; however, successful surgery for extradural hemorrhage dates
Raney RB, Raney AA, Peterson EW. EMERGENCY CARE OF SUSPECTED MIDDLE MENINGEAL HEMORRHAGE: TECHNICAL SUGGESTIONS FOR THE GENERAL SURGEON. JAMA. 1953;153(16):1434–1435. doi:10.1001/jama.1953.02940330018006
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