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September 26, 1959


Author Affiliations

Columbus, Ohio

From the Department of Surgery, Neurosurgery Division, Ohio State University Medical Center.

JAMA. 1959;171(4):405-408. doi:10.1001/jama.1959.03010220029008

The patient with head injuries leading to extradural hematoma is most likely to pass through three stages: unconsciousness, a lucid interval, and recurrence of unconsciousness, with rapid deterioration. The relapse into unconsciousness denotes fulminating extradural hematoma and demands immediate action; the patient in this stage can no more tolerate delay than can a patient with respiratory obstruction. He cannot be transported long distances, and his hope lies in the general surgeon who first attends him. Usually, as in this case of a man injured in a motorcycle accident, the bleeding is from a branch of the middle meningeal artery. The operation here described provides an opening in the temporal bone to relieve intracranial presssure, allow blood to escape, and permit electrocoagulation of the bleeding point.