| Sir Victor Horsley's contributions to the study and treatment of gunshot wounds of the head. | |
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MedLine Citation:
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PMID: 18981893 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Sir Victor Horsley'S many contributions to neurological surgery include experimental and clinical studies of gunshot wounds (GSW) of the head. Horsley's publications from 1894 to 1897 and 1914 to 1915 on GSWs were reviewed. Horsley described GSWs in animal and clay models, illustrating characteristics of the primary missile tract and secondary cavitation. A transcranial GSW model in 67 dogs related intracranial damage to the projectile's velocity and sectional area, producing a marked sudden increase in intracranial pressure that presumably "tunneled" to the medullary respiratory and cardiac centers. If the resultant sudden apnea was treated with artificial respiration and prompt surgical decompression, the animal often survived. In these animal experiments, Horsley clearly described increased intracranial pressure, hypertension, and bradycardia-later recognized as the Cushing response or triad. With the onset of World War I, Horsley again reviewed the ballistics of military weaponry, emphasizing projectile spin and velocity as the main wounding mechanisms. He was outspoken against the "wicked tradition" of neglecting cranial GSWs and personally treated cases with aggressive respiratory support and prompt decompression of devitalized tissue. Horsley's contributions to the experimental and clinical aspects of GSWs to the head are consistent with his other important contributions to neurosurgery and have largely stood the test of time. |
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Authors:
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George R Cybulski; James L Stone; Ketan J Patel |
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Publication Detail:
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Type: Biography; Historical Article; Journal Article |
Journal Detail:
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Title: Neurosurgery Volume: 63 ISSN: 1524-4040 ISO Abbreviation: Neurosurgery Publication Date: 2008 Oct |
Date Detail:
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Created Date: 2008-11-04 Completed Date: 2009-01-09 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7802914 Medline TA: Neurosurgery Country: United States |
Other Details:
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Languages: eng Pagination: 808-11; discussion 811-2 Citation Subset: IM |
Affiliation:
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Department of Neurosurgery, Division of Neurosurgery, Stroger Hospital of Cook County, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA. gcybulskineurosurg@hotmail.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Animals Apnea / etiology, therapy Dogs Head Injuries, Penetrating / history*, surgery, therapy History, 19th Century History, 20th Century Humans Intracranial Hypertension / etiology, surgery Neurosurgery / history* World War I Wounds, Gunshot / history*, surgery, therapy |
| Personal Name Subject | |
Personal Name Subject:
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Victor Horsley |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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