. Medical and surgical therapy . thors as a means of settling the question ofinjury of the brain (see Chapter III.). in. Cranio-cerebral Topography Having obtained a description of the wound, it isimportant to localise it. After measuring its dimensions, it can be approxi-mately localised by the following method :— The centre of the hole in the bone is situated so manycentimetres to the right or to the left of the medianline ; so many centimetres above and in front of (orbehind) the external auditory meatus, or above theroot of the nose, or above the external occipital pro-tuberance, according
. Medical and surgical therapy . thors as a means of settling the question ofinjury of the brain (see Chapter III.). in. Cranio-cerebral Topography Having obtained a description of the wound, it isimportant to localise it. After measuring its dimensions, it can be approxi-mately localised by the following method :— The centre of the hole in the bone is situated so manycentimetres to the right or to the left of the medianline ; so many centimetres above and in front of (orbehind) the external auditory meatus, or above theroot of the nose, or above the external occipital pro-tuberance, according to the site of the wound. Sucha localisation, however, is very vague, and of little OF THE PATIENT 501 value. It is of much more value to fix the site of theloss of substance definitely, relatively to the subjacentcerebral convolutions ; to attempt, in short, to makea cranio-cerebral localisation. To carry out thislocalisation on the living subject with anything ap-proaching exactitude it is absolutely necessary to. P^io. 1.—Frontal typo of skull. The brain is pushed up in front; tlie,. lissure of Rolando approaelies the vertical. (The dotted linesreiwesent the sutures. The continuous lines represent the fissuresand sulci of <ho brain.) lay dchvn certain datum-points and to measure certaindimensions witli a flexible measuring tape. Theto})ograpliy of tlie wound can be laid down approxi-mately, with only a small margin of error, if it isborne in mind that there are two great types of cranialformation, wliich we may name respectively Frontaland Occipital (Froriep). In the frontal type the brain is. as it were, pushed 5C2 WOUNDS OF THE BRAIN forward, the fissure of Rolando being far forward andnearly vertical. In the occipital type the brain seems to have beentipped backwards on an axis passing transverselythrough the external auditory meatus on each side,the fissure of Rolando is far back, its posterior ex-
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectsurgery, bookyear1918
