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June 30, 1900


JAMA. 1900;XXXIV(26):1658-1660. doi:10.1001/jama.1900.24610260002001a

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Trephining of the cranium in cases of injury has now become so common that the general indications are fairly well known. The number of head injuries which now demand operation has increased greatly in the last few years, before which time only compound depressed fractures were so treated.

I wish to call attention to certain non-traumatic conditions in which operation is useful. It has long been known that in cases of increased intracranial pressure due to tumors, trephining, especially when combined with opening of the dura, may afford great relief from pain and general pressure symptoms.

I do not think, however, that it has been made sufficiently plain that this treatment—trephining with such additional operation as may be needed—is often advisable in cases of increased intracranial pressure when the cause of the increase is uncertain. In cases of intracranial tumor, the trephining has usually been done to relieve pain. In

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