Wounds in war : the mechanism of their production and their treatment . Fig. Inner table opposite groove in outer table. —Netley Museum. of elevation or removal of fragments, or for washing outblood clots and the ligature of bleeding vessels. When,later in the case, symptoms of cerebral or meningeal in-. GUNSHOT FRACTURES OF THE SKULL 263 rlammation,or of compres-sion from haemorrhage,supervene, similar treat-ment should be adoptedwithout delay, Fissured fractures ofboth tables, with or with-out obvious depression,are extremely common;and, although depressionof the outer table may notbe
Wounds in war : the mechanism of their production and their treatment . Fig. Inner table opposite groove in outer table. —Netley Museum. of elevation or removal of fragments, or for washing outblood clots and the ligature of bleeding vessels. When,later in the case, symptoms of cerebral or meningeal in-. GUNSHOT FRACTURES OF THE SKULL 263 rlammation,or of compres-sion from haemorrhage,supervene, similar treat-ment should be adoptedwithout delay, Fissured fractures ofboth tables, with or with-out obvious depression,are extremely common;and, although depressionof the outer table may notbe apparent or may bevery slight, depression ofthe inner table, and muchgreater damage to it thanto the outer, may be in-ferred as certain (figs. 69,A and B). In the Ameri-can War 2911 cases ofthis kind are recorded, ofwhich 1826 proved account of the depres-sion and excessive splin-tering of the inner table,and because more or lessextravasation of bloodmust occur, causing moreor less compression of thebrain, immediate trephin-ing is indicated in thesefractures. In some cases, espe-cially when the bulletimpinges on the skullobliquely, the missile maybecome split against theedge of the fissure, onepart entering the cavity ofthe cranium, and the other Fig. 69B. passing On Or lodging be- Fraclure wi
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