Intra-cranial lesions : introductory remarks on the following questions / by W.W. Keen.

  • Keen, William W. (William Williams), 1837-1932.
Date:
1890
Catalogue details

Licence: Public Domain Mark

Credit: Intra-cranial lesions : introductory remarks on the following questions / by W.W. Keen. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    cases of headache and allied disorders, in which perhaps the chief value of the trephining lies in the alteration of intra- cranial pressure, the bone should not be replaced. In all other cases I have replaced it without at least any deleterious results, and I am inclined to think with advantage. If the bone is to be replaced, provision must be made beforehand for its care by placing it in a 1-2,000 sublimate solution, and it should be the sole duty of one assistant to see that this is kept at a temperature of 100° to 105° F. by means of hot water outside the cup or bowl in which the bone is placed. I have never had any trouble in replacing a disc as large as an inch and a half, and I prefer to do this rather than to spend time in chipping it up. But if the bone be greatly thickened, it should not be replaced in mass, but either bitten into small i^ieces, or, if the bone be diseased, it should be rejected entirely. The suggestion of Senn to close the opening by means of decalcified bone is a valuable one, especially where there has been a prior loss of substance. It has also one marked advantage in that it can be better fitted to the opening than ordinary hard bone. TOPIC. V.—EESULTS. These I will consider as to each disease or injury as briefly as possible. I shall not use the statistical method, but rather give the general conclusions I have reached, based both on my own experience and on a fairly thorough acquaintance with the literature of the subject. The topics as announced exclude from this paper the consideration of fractures of the skull, but I cannot help congratulating the profession on the development of cranial surgery in the treatment of these extremely serious injuries, and to urge that operative treat- ment shall be used more freely than was formerly the case, not only with a view to the immediate saving of life, but to the prevention of later disorders, especially of epilepsy. ABSCESS. No good surgeon will now liesitate to operate in a case of abscess of the brain. If there have been chronic middle-ear