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January 1939


Arch Surg. 1939;38(1):24-54. doi:10.1001/archsurg.1939.01200070027003

In 1925 Cushing and Putnam1 published reports of 11 cases of subdural hematoma in which the condition apparently arose as the result of trauma to the head. At the same time they summarized the theories regarding the nature of this lesion and discussed its relation to the pachymeningitis haemorrhagica interna described by Virchow.2 They expressed the opinion that the only pathologic difference between the two is in the microscopic appearance of the membranes of the hematoma, the traumatic form possessing large mesothelial-lined spaces and smaller capillaries. They also concluded that late hemorrhages into the sac are of common occurrence. In 1927 Griswold and Jelsma,3 in a similar study, concluded that the microscopic appearance of the membranes was the same in both forms. Whatever the relation between the two forms of subdural hematoma, these papers served to emphasize the importance of trauma as a cause, if not the

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