Transactions of the Pathological Society of London (Volume 36) (Paperback)

This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1885. Excerpt: ... VI. DISEASES, ETC., OF THE OSSEOUS SYSTEM. 1. Two cases of simple fracture of the skull in infants, followed by the development of a pulsating subcutaneous tumour. By Rickman John Godlee, M.S. The two following cases seem to me worthy of being recorded in the 'Pathological Transactions, ' because they belong to a class of fractures of the skull which though rare are evidently not very uncommon, but which receive so little notice in surgical textbooks that it is probable that most surgeons, as I did, will think, when they first meet with a case, that they have happened upon an altogether undescribed condition. The fracture referred to can apparently, for reasons to be afterwards stated, only occur in young children; it is a simple fracture and is accompanied at the time of the accident by what appears to be an ordinary haematoma beneath the periosteum; but this hematoma is noticed either immediately or after the lapse of a certain time to pulsate more or less forcibly synchronously with the heart's beats, and to be liable to a powerful impulse when the patient coughs or cries. It does not behave like an ordinary haematoma, moreover, but instead of diminishing in size is disposed to enlarge or remain stationary, and may continue without much alteration for an indefinite period of time. Eventually it is found that there is an aperture of considerable size in the skull, and, if the child dies, not only is the dura mater discovered to be ruptured, but in many, if not in all cases, the brain itself is seen to have suffered a serious injury not unfrequently involving an actual opening into the ventricular cavity. With this preface I will proceed to describe my two cases, taking first that which happened second in order of time. Ellen B--, aged 8 months, was admit...