Report on the Progress of Surgery

H. L. BURRELL, H. W. CUSHING
1887 Boston Medical and Surgical Journal  
There have been a few important contributions to the surgery of the brain. Mr. Victor Horsley's paper ' read at the last annual meeting of the British Medical Association, gives the details of operating on the brain and the dangers that arise in the after-treatment of such cases. The following cases are recorded, all of which were successful. Two trephinings for traumatic epilepsy ; the removal of a tubercular tumor from its previously located position at the junction of the lower and middle
more » ... lower and middle thirds of the ascending frontal convolutions. The cases of Mr. Horsley, Dr. Clark, of Glasgow, and the recent case of Hughes Bennett and Pearce Gould 2 seem to indicate that trephining for traumatic epilepsy, is becoming an established operation ; It is certainly a justifiable, although not always a successful operation. On the other hand, the removal of tumors from the brain substance is not as encouraging. Four cases havebeen recorded ; the case of Mr. Godlee8 and Dr. Bennett, which cannot be regarded as successful, a case by Dr. Kirschfelder, of San Francisco, in which death occurred on the seventh day ; Mr. Horsley's successful case ; and the successful removal by Dr. Durante, of Rome, of an endo-cranial tumor from the base of the skull. Of interest from a practical point of view is the London Pathological Society's exhibit of cerebral tumors * in which out of forty-four specimens of intracranial growth, only two would be suitable for an operative attack. COMPRESSION OF THE BRAIN. E. von Bergmann in a recent report,5 an interesting review of which has already appeared,6 states that the mechanical action in compression of the brain, is similar to progressive cerebral anasmia from other conditions. That the blood is driven from the capillaries by pressure, as water from a sponge, causing impaired nutrition, the effect of which is first irritation and sub-
doi:10.1056/nejm188703171161103 fatcat:mqn2jx5y5bgjrhxumykydn7sey