Epilepsy and Gunshot Wounds of the Head

Stevenson, William E.

doi:10.1093/brain/54.2.214

Cited by 17 publications

(2 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It was recorded at 137 % during the American Civil War and at 4-3 % during the Franco-Prussian war (Turner, 1923). Among the British soldiers with missile wounds of the head during the first world war, Sargent (1921) reported an incidence of 4-5%, Rawling (1922) 25%, Wagstaffe (1928) 9-8%, Stevenson (1931) 1-5%, Ascroft (1941) 34%, Denny-Brown (1942) 8A4%;and Credner (1930) documented an incidence of 38% among Germans with war head injuries. In a five-year follow-up of 820 brain-wounded patients from the second world war, Russell and Whitty (1952) found that 43% had epileptic seizures; in another series of 286 patients Watson (1952) observed that 36 % and 41 6% had epilepsy within two and three years of wounding respectively, and Walker and Jablon (1959) recorded an incidence of 28% among United States soldiers with military head injuries.…”

mentioning

confidence: 98%

Epilepsy after missile wounds of the head

Adeloye

1971

Journal of Neurology, Neurosurgery & Psychiatry

View full text Add to dashboard Cite

SUMMARY Two hundred and thirty-seven Nigerians with missile head injury were treated at the University College Hospital (UCH) lbadan, between July 1964 and January 1970. Among the 165 of these patients who have been followed up for over a year, the incidence of epilepsy has been 11-4 %, 18-75%, and 333 % in a follow-up period ranging between one to two years, two to three years, and three to five years respectively.Wounds in the parietal region, especially those at the vertex, were followed by epilepsy more frequently than injuries elsewhere on the head. Of these wounds, tangential skull injuries and through-and-through brain injuries were more epileptogenic than others.Fits which occurred within a fortnight of wounding have been designated as 'early' fits, and they appeared to differ in their aetiology from 'late' fits.The phenomenon of epilepsy occurring after injuries to the head must have been observed in the prehistoric era when man first clubbed man, but the earliest documented reference to the problem of post-traumatic epilepsy is credited by common consent to Hippocrates. He recorded right-sided convulsive seizures which followed injury to the left cerebral hemisphere, a contribution which kindled interest in the surgical aspects of traumatic epilepsy on which a vast amount of literature had accumulated by the middle of the sixteenth century (Davis, 1953). In later years, the wars in America, Europe, and Korea provided material for the study of epilepsy after missile wounds of the head. The type of injuries studied, the period after wounding selected for these studies, and the duration of observation varied from series to series so that the frequency of post-traumatic epilepsy in missile head wounds had been variously estimated by different observers. It was recorded at 137 % during the American Civil War and at 4-3 % during the FrancoPrussian war (Turner, 1923). Among the British soldiers with missile wounds of the head during the first world war, Sargent (1921) reported an incidence of 4-5%, Rawling (1922) 25%, Wagstaffe (1928) 9-8%, Stevenson (1931) 1-5%, Ascroft (1941) 34%, Denny-Brown (1942) 8A4%;and Credner (1930) documented an incidence of 38% among Germans with war head injuries. In a five-year follow-up of 820 brain-wounded patients from the second world war, Russell and Whitty (1952)

show abstract

mentioning

confidence: 98%

Epilepsy after missile wounds of the head

Adeloye

1971

Journal of Neurology, Neurosurgery & Psychiatry

View full text Add to dashboard Cite

show abstract

“…If after two or three fits the patient is free from attacks for two years, it is unlikely that he will become an habitual epileptic. Stevenson [14] puts the figure after war injuries at about 40%. The first major convulsion is frequently preceded by attacks of petit mal, some of which come on at night, so that they pass unobserved.…”

mentioning

confidence: 99%

On Injuries to the Brain and Their Sequelæ

Jg¹

1939

Proceedings of the Royal Society of Medicine

View full text Add to dashboard Cite

THE Great War and the ubiquitous motor car have revolutionized our outlook on head injuries, so that for the past two decades less attention has been paid to fraetuires of the skull, and more to damage of the intracranial contents. Indeed in a series of 441 cases of head injury Maclure and Crawford found 39%0 of them to be free from fracture of the skull [1]. Except in cases of compound fractures, penetrating gunshot wounds, that rare form of extradural hbimorrhage due to injury of the middle meningeal vessels, and, less urgently, in cases of depressed fracture causing irritation, the modern trend is towards non-interference; and, whilst combating the risks of sepsis, the surgeon tries to assess the cerebral damage. Trotter [2] has observed that " kinetic energy (on which the seriousness of accidents obviously depends) varies with the mass and the square of the velocity of the moving bodies concerned ". Thus if an accident occurs in horse traffic moving at 10 imiles per hour, and a motor accident occurs when moving at 30 miles per hour, the kinetic energy involved in the latter case is not three, but nine times that of the former. The same law applies to the bullets of war-time and the blasts of mines and high explosive missiles.Concussion.-In all head injuries of any severity there is an initial stage, known clinically as "c oncussion ". This may be a momentary stunning of the patient, or something longer. Trotter [3] defines it as an essentially transient state due to head injury, which is of instantaneous onset, manifests widespread symptoms of a paralvtic kind, does not, as such, comprise any evidence of structural injury, and is always followed by amnesia for the actual moment of accident No one has challenged Trotter's postulates for the state of concussion, but several have dissented from his view as to its causation. Following Kocher, he thought it was duie to cerebral anTmia, the result of sudden deformation of the skull at the moment of accident. This view has been endorsed by several authorities, but NOV. UNIT. SER. 1

show abstract

Convulsive Seizures in Adult Life

Walker¹

1936

Arch Intern Med

View full text Add to dashboard Cite

Epilepsy and Gunshot Wounds of the Head

Cited by 17 publications

References 0 publications

Epilepsy after missile wounds of the head

Epilepsy after missile wounds of the head

On Injuries to the Brain and Their Sequelæ

Convulsive Seizures in Adult Life

Contact Info

Product

Resources

About