The next day the discharge became
watery, and in it were found small pieces of true
brain-substance. In five weeks the man returned to duty
complaining only of giddiness and of a "stuffed-up" head. In 1846
there is a record of a man of forty who fell from a scaffold,
erected at a height of 20 feet, striking on his head. He was at
first stunned, but on admission to the hospital recovered
consciousness. A small wound was found over the right eyebrow,
protruding from which was a portion of brain-substance. There was
slight hemorrhage from the right nostril, and some pain in the
head, but the pulse and respiration were undisturbed. On the
following day a fragment of the cerebral substance, about the
size of a hazel-nut, together with some brood-clots, escaped from
the right nostril. In this case the inner wall of the frontal
sinus was broken, affording exit for the lacerated brain.
Cooke and Laycock mention a case of intracranial injury with
extensive destruction of brain-substance around the Rolandic
area; there was recovery but with loss of the so called muscular
sense. The patient, a workman of twenty-nine, while cutting down
a gum-tree, was struck by a branch as thick as a man's arm, which
fell from 100 feet overhead, inflicting a compound comminuted
fracture of the cranium.
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