The Surgery of the Skull and Brain

by Louis Bathe Rawling

Treatment.

With the object of reducing the infectivity of the protruding brain, fomentations have been advocated. From my own experience, however, it would appear that their application tends to increase the degree of protrusion, and that better results may be obtained by keeping the exposed brain as dry as possible, painting over with a 2¹⁄₂ per cent. solution of iodine in rectified spirit, dusting with antiseptic powder, and protecting with dry dressings, frequently replaced.

In the event of failure to improve the condition by means of these minor remedies—a too-frequent occurrence—excision of the protruding mass may be regarded as a perfectly justifiable procedure, providing that the hernia does not include the cerebellum or motor cortical region. The protrusion is shaved away flush with the level of the skull, the raw surface of the brain lightly painted with iodine, dusted with iodoform or other antiseptic powder, and protected with gauze and wool.

The prognosis is necessarily most grave, but the most astounding recoveries have taken place under this mode of treatment.

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[52] Archiv für Ohrenheilkunde, vol. xxix, p. 17.

[53] Diseases of the Ear, Oxford Medical Publications, p. 257.

[54] Pyogenic Diseases of the Brain and Spinal Cord.

[55] Some Points in the Surgery of the Brain, p. 95.

[56] Macewen, Pyogenic Diseases of the Brain and Spinal Cord.