0
JAMA 100 Years Ago |

Gunshot Wound of Brain

JAMA. 2010;304(5):585. doi:10.1001/jama.2010.1016.
Text Size: A A A
Published online

Extract

In the first case cited by DaCosta a No. .22 bullet was lodged in the brain for eight months, producing amnesia and convulsions. It was removed successfully. Convulsions were arrested but the amnesia was not improved. In this patient the shock caused partial amnesia; the bullet, encysted just beneath the cortex, caused convulsions, and DaCosta suggests that in all probability, when the tearing loose of the bullet from the wall which encysted it took place, the bullet moved about and the irritation led to the development of status epilepticus. An interesting fact is that a No. .22 bullet should have pierced an ordinary thick skull and reached the opposite side of the head. In the second case, a bullet of .32 caliber, in the brain for over four weeks, caused violent headache and was successfully removed with complete recovery. The bullet was lodged in the falx and against the superior surface of the straight sinus. The whirr of the blood in that sinus was very distinct as the finger pushed against the bullet. The falx was incised, the bullet was exposed and removed with bullet forceps. On its removal there was a great gush of blood, presumably from the sinus. The bleeding was arrested by gauze packing which made much pressure on the falx and tentorium. Because of the large amount of gauze employed, the fear of further hemorrhage, and the apprehension as to the results of compression, the bone flap was removed and the scalp sutured about the protruding gauze. The man reacted quickly from the ether and a few hours after the operation was perfectly conscious and free from pain. The packing was not removed for nine days. On its removal there was no bleeding. The patient at present is in excellent health.

Topics

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

References

CME
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Response

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Jobs