A Clinical Observation on Craniocerebral Injuries in Adults: Analysis of 1547 Cases

During the five years from 1972 to 1976, 2308 cases of head injury were admitted to Han Kang Sung Shim Hospital and were treated in the department of neurosurgery. Of these, 1547 were adults aged 16 and over, and 761 were infants and children up to the age of 15. The results of clinical analysis of 761 cases of above series have been reported early in 1977. In this paper, a clinical analysis of 1547 adult cases of above series was performed and following results were obrained. 1) There were 1077 males and 470 females, and the proportion of male was much greater than female, male-female ratio was 2.3:1. 2) The age incidence was greater in the age group between 16 to 40, becoming maximal at the second decade. 3) Traffic accidents form by far the largest group (62%), and next are, in order of incidence, accidents due to blow or assault, fall from a height, simple fall, and industrial accidents. 4) Among the 1547 patients investigated, 20 of 1275 cases those conscious or confused on admission were died and 103 of 272 those semicomatose or comatose were died. 5) Skull fractures were seen in 504 cases, and nearly half of those, 242 or 48%, were linear fractures. 6) Of the 333 patients with intracranial hemorrhage or subdural hygroma, 181 were accompanied by skull fracture and epidural hematoma showed highest incidence, 80.46%. 7) Of 87 epidural hematoma, 69(79%) were found in the temporal and parietal fossae of the skulls, and of 70 subdural hematoma, 60(85.7%) were found in the parietal and temporal surface of brains. 8) Operation were carried out in 228 patients and surgical mortality was 24.5%, and subdural hematoma showed highest mortality, 40.0%. 9) Among the 228 surgical cases mortalities were 30% in those operation have been carried out within 6 hours of injury, 24% in those within hours 6 to 24, and 14% in those after 24 hours. The earlier the surgery had to be carried out, the higher operation mortality was noted. 10) The overall mortality in this series was 7.95%.

A Case of Primary Osteogenic Sarcoma of the Thoracic Spine with Paraplegia

Osteogenic sarcoma arise from primitive bone forming mesenchyme which is transformed into neoplastic osteoid and bone. Most osteogenic sarcomas originate in long bone, only rarely do they occur as primary tumor of the spine. A case is presented in which a patient who had suffered from paraplegia and self voiding difficulty. It was diagnosed as osteogenic sarcoma of the 5th thoracic spine which was operated and confirmed by microscopically, and is discussed with a brief review of the literatures.

A Clinical Observation on Craniocerebral Injuries in Infants and Children(Analysis of 481 Cases)

Clinical observation and analysis were performed on 481 cases of craniocerebral injuries under 15 years of age those were treated at Chung-ang University hospital during the period from January, 1972 to August, 1975. Following results were obtained: 1. There were 302 males and 179 females and sex ratio was 1.7:1. 2. Age incidence of the accidents was greatest at 5 years of age and mostly distributed to the age group between 5 to 7. 3. Seasonal peak of the accidents was at June. 4. The most frequent cause of the craniocerebral injuries was traffic accident(277 cases, 57.59%), and the next was fall from height(159 cases, 33.06%). 5. No deterioration of consciousness before and after the admission was observed in 176 cases(3.6%). 6. Pupillary change was observed in 28 cases in which unilateral were 21 and bilateral were 7. Babinski sign was elicitable in 91 cases. 7. Early convulsion and vomiting were frequent symptoms in childhood. 8. Skull fracture was observed in 204 cases(40.33%) in which linear fracture was most frequent. The location of the linear fracture was parietal and the predilection sites of the depressed fractures were frontal and parietal. 9. The accompanying rate of skull fracture in intracranial hemorrhage was;epidural 75%, subdural 50% and subarachnoid 17.3%. 10. The overall mortality was 8.32%. In non-surgical group(442 cases), the mortality rate was 7.47% but in surgical group(39 cases), operation mortality was 17.95%.