The right eye was contused but the
pupils equal; the vertex-wound was full of brain-substance and
pieces of bone, ten of which were removed, leaving an oval
opening four by three inches. The base of the skull was fractured
behind the orbits; a fissure 1/4 inch wide was discernible, and
the right frontal bone could be easily moved. The lacerated and
contused brain-substance was removed. Consciousness returned six
days after the operation. The accompanying illustrations (Figs.
196 and 197) show the extent of the injury. The lower half of the
ascending frontal convolution, the greater half of the sigmoid
gyrus, the posterior third of the lower and middle frontal
convolutions, the base and posterior end of the upper
convolution, and the base of the corresponding portion of the
falciform lobe were involved. The sensory and motor functions of
the arm were retained in a relative degree. There was power of
simple movements, but complex movements were awkward. The tactile
localization was almost lost.
Morton mentions a patient of forty-seven, who was injured in a
railroad accident near Phoenixville, Pa.; there was a compound
comminuted fracture of the skull involving the left temporal,
spheroid, and superior maxillary bones.
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