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On the mechanism of brain injuries. By Alexander Miles, MD, FRCS. Edin. Syme Surgical Fellow (From the Laboratory of the Royal College of Physicians, Edinburgh) Brain 1892: 15; 153–189; Experimental cerebral concussion. By D. Denny Brown and W. Ritchie Russell (From the Laboratory of Physiology, Oxford) Brain 1941: 64; 93–164
Cambridge
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That a bang on the head may prove fatal has been known since Biblical times. Despite the celebrated description by Alexis Littré in 1705 of a condemned criminal who anticipated his executioner by head-banging until dead but without breaking his skull, the nature of fracture-less head injury is not so clear. Although many doubt that this can happen, no less an authority than Mr Jonathan Hutchinson has argued that violence of the shake may itself lead to death. Do uncontrolled brain vibrations follow rapid alteration in shape of the skull (as proposed by Professor Miller of Edinburgh)? Perhaps not, since the brain has some freedom of manoeuvre in the cranium: it is a hollow structure, requiring I atmosphere pressure to cause compression by 1/25 000th of its volume; and the meninges or tentorium must tear in the face of such distortions. Is it due to diffuse petechial haemorrhage and cerebral