Document Detail


Sir Victor Horsley's contributions to the study and treatment of gunshot wounds of the head.
MedLine Citation:
PMID:  18981893     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
George R Cybulski; James L Stone; Ketan J Patel
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Publication Detail:
Type:  Biography; Historical Article; Journal Article    
Journal Detail:
Title:  Neurosurgery     Volume:  63     ISSN:  1524-4040     ISO Abbreviation:  Neurosurgery     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-11-04     Completed Date:  2009-01-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  808-11; discussion 811-2     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, Division of Neurosurgery, Stroger Hospital of Cook County, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA. gcybulskineurosurg@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
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:
Victor Horsley

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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