Acute Craniocerebral Trauma

Abstract

should be treated as an individual problem and not repaired by any routine procedure. However, I do feel that for large indirect hernias which have caused atrophy of the surrounding tissues, the method of repair should be the same as that for direct hernias. The method of treating small inguinal hernias simply by removing the sac was initiated by Russell many years ago in Australia. One of his pupils, Craig, recently published an article in which he said that that simple operation must be supplemented by something else. His first supplemental method was implantation of phenol and olive oil in the exposed area of transversalis fascia. I will leave that with you for what it is worth. The second method was turning in the hernia sac and afterward suturing the edges. He made the state¬ ment that the sutures will not pull out because the tissues of transversalis fascia are very strong and will hold the sutures. I am certain that that statement is at variance with the experience of many surgeons in many cases in which it has been impossible to find any transversalis fascia at all. Dr. Coley objected to the Halsted operation in the transplantation of the cord subcutaneously. He said that putting both the internal and external ring over each other might tend to indirect recurrence. It might, of course, but I don't believe that it does in most instances, because it is well known that most recurrences are direct occurrences that occur close to the pubic bone. If the indirect sac is thoroughly taken away, one just doesn't get recurrences at the internal ring. I agree with everything Dr. Coley said about early ambulation.

A Case-Based Review of the Management of Penetrating Brain Trauma

“…Overall, 90% of civilian GSWs are lethal [1]. Principles to guide treatment of GSWs are outlined by Grahm (Table 1) and Matson (Table 2) [2-3]. …”