Head Injuries

Mass production of automobiles has produced "A typical American mass production of head injuries." Thus famed Chicago Surgeon Percival Bailey wrote in an introduction to Diagnosis and Treatment of Head Injuries, by Drs. Sidney William Gross & William Ehrlich (Hoe-ber; $5), published last week. Terse and clear, the handbook tells general practitioners as well as surgeons exactly what to do with the estimated 80,000 banged heads they meet every year. Practical tips: P: The human skull, an average of one-fifth of an inch thick, is so elastic that often a heavy blow from a blunt instrument only dents it "momentarily." Yet in such cases the tender brain is almost always wounded. In auto accidents, "when a head in forward motion is suddenly arrested by a massive stationary object, the greatest brain damage occurs at a point directly opposite the point of impact. P:Even patients who are unconscious "only for a moment" should never be sent home, but should be put to bed for two or three weeks. For many cases of brain injury do not show up until several hours or even days later. P: All severely injured brains are flooded with blood and spinal fluid. Many doctors believe that small amounts of surplus fluid must be drawn out to relieve pressure. that patients should be denied liquids. But Drs. Gross & Ehrlich consider drastic dehydration dangerous, achieve the same result in another way. They give hypertonic (heavy) glucose injections to patients in coma or shock. The glucose, thicker than body fluids, sucks out fluid from the tissues through osmotic pressure. thus reduces tension in the brain. P: Also harmful, say Drs. Gross & Ehrlich. is the common practice of lumbar puncture (spine-tapping) to examine the spinal fluid soon after a head injury. During the first few hours after the accident, the body tries to restore the balance between blood and cerebro-spinal fluid. Withdrawal of fluid "might possibly interfere with this."

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