MANAGEMENT OF HEAD INJURIES WITH REAL OR POTENTIAL BRAIN DAMAGE

Abstract

During the last year, the relatively large number of cases of head injury admitted to the Grady Memorial Hospital (colored division) has afforded an unusual opportunity to work out a definite policy in the management of such cases, and one attended with a degree of success justifying this review. CLASSIFICATION OF CASES We have learned to classify cases of head injury thus: Massive brain injury, with evidence of rapid exhaustion of the medullary centers, and death within one to several hours after admission. Definite evidence of middle meningeal hemorrhage. Simple or compound depressed fracture, with localized brain contusion, with or without indriven bone fragments. Classic manifestations of rapidly increasing intracranial pressure which are well within the period of medullary compensation. Definite evidence of brain injury exhibiting no classic findings of acutely increasing intracranial pressure, yet of the type that experience has shown is liable to develop gradually increased intracranial pressure