Since the vast majority of head injuries are of necessity treated by the industrial surgeon, this paper dealing with the diagnosis and the management of the only real surgical emergency among head injuries—the interval or delayed intracranial hemorrhage—should be of interest to him.
Interval hemorrhage is delayed intracranial bleeding that develops in either the extradural or the subdural space after an injury to the head. The injury may be slight; usually it is of sufficient severity to produce momentary unconsciousness. I have seen 4 professional boxers with interval hemorrhage after they had received a knockout blow in the ring. Twenty-two of the patients in this series of 25 suffered only a minor injury. Eleven had no period of unconsciousness.
The typical interval hemorrhage involves the middle meningeal artery. The sequence of events in this type of bleeding is as follows: The patient receiving a blow to the head, usually
SELETZ E. INTERVAL INTRACRANIAL HEMORRHAGE: ITS DIAGNOSIS AND MANAGEMENT: ANALYSIS OF TWENTY-FIVE CASES. Arch Surg. 1942;45(1):177–182. doi:10.1001/archsurg.1942.01220010180014
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