Fracture of the base of the skull has boasted of a mortality of 64 per cent., and only during the period of. the past five years has this high fatality shown any decrease. The treatment up to 1906 was a tentative one, marked by such erratic measures as drugs, lumbar puncture, venesection andexpectant measures, and only since the experimental researches of Leonard Hill, Cushing and Krause have we known the rationale of decompression in such lesions.
The understanding from these experiments of how blood at the base produces both a local and general increase of intracranial pressure and how this pressure causes death through anemia of the vital centers in the medulla, will readily explain the rationale of decompression operations for fracture of the base.
During a meeting of southern railway surgeons at Birmingham, in 1906, I took the stand that exploratory decompression for basal fracture was the only correct
PAYNE RL. DECOMPRESSION OPERATIONS FOR FRACTURES OF THE BASE OF THE SKULL. JAMA. 1912;LVIII(7):472–473. doi:10.1001/jama.1912.04260020156008
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