Traumatic Subdural Effusions

Group 1.-Patients whose condition was deteriorating, usually within 48 hours of the accident (8 cases).Group 2.-Patients who were in the process of recovery from definite general cerebral contusion, but in whom full recovery seemed to have been checked.Group 3.-Patients suffering from headache, dizziness, and vague symptoms of nervous instability dating from a head injury.Group 4.-Patients in whom headache and occasionally some definite nervous system, constant for the individual, started some time after a head injury.Case reports illustrative of each of these types will be given.GROUP 1.-Patients whose condition was deteriorating, usually within 48 hours of the accident (8 cases).Case 1.-A.N., male, aged 30, was arrested after a street fight, and spent the night in prison.Next morning he was found to be drowsy, slow in answering, and the pulse rate was 50.There was a small scalp wound on the right side.No focal signs could be found.On the diagnosis of extradural haemorrhage an opening was made in the right temporal region.There was no blood outside the dura, but when the latter was opened a large quantity of clear fluid under great tension rushed out, leaving the brain depressed for more than a centimetre.The patient made a rapid and complete recovery.He remembered every detail of the fight and the blow on the head.Case 2.-M.E., female, aged 14 months.Admitted 20th