Sir Victor Horsley's contributions to the study and treatment of gunshot wounds of the head.

Full Abstract

Sir Victor Horsley'S many contributions to neurological surgery include experimental and clinical studies of gunshot wounds (GSW) of the head. Horsley's publications from 1894 to 1897 and 1914 to 1915 on GSWs were reviewed. Horsley described GSWs in animal and clay models, illustrating characteristics of the primary missile tract and secondary cavitation. A transcranial GSW model in 67 dogs related intracranial damage to the projectile's velocity and sectional area, producing a marked sudden increase in intracranial pressure that presumably "tunneled" to the medullary respiratory and cardiac centers. If the resultant sudden apnea was treated with artificial respiration and prompt surgical decompression, the animal often survived. In these animal experiments, Horsley clearly described increased intracranial pressure, hypertension, and bradycardia-later recognized as the Cushing response or triad. With the onset of World War I, Horsley again reviewed the ballistics of military weaponry, emphasizing projectile spin and velocity as the main wounding mechanisms. He was outspoken against the "wicked tradition" of neglecting cranial GSWs and personally treated cases with aggressive respiratory support and prompt decompression of devitalized tissue. Horsley's contributions to the experimental and clinical aspects of GSWs to the head are consistent with his other important contributions to neurosurgery and have largely stood the test of time.

Author information

Author/s: Cybulski, George R (GR); Stone, James L (JL); Patel, Ketan J (KJ);

Affiliation: Department of Neurosurgery, Division of Neurosurgery, Stroger Hospital of Cook County, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA. gcybulskineurosurg(-atsign-)hotmail.com

Journal and publication information

Publication Type: Biography; Historical Article; Journal Article

Journal: Neurosurgery (Neurosurgery), published in United States. (Language: eng)

Reference: 2008-Oct; vol 63 (issue 4) : pp 808-11; discussion 811-2

Dates: Created 2008/11/04; Completed 2009/01/09;

PMID: 18981893, status: MEDLINE (last retrieval date: 2/18/2009, IMS Date: )

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

External Links for this article
(including full text providers, if available):

Click Electronic Full-text Provider Links to see options for finding the electronic full text links to this article. Note there may be a subscription or fee required for access to the full text. See our FAQ for information on finding FREE full text articles.

This article may also be located in paper journal collections available in many libraries. Use the Journal and Publication Information above to find the full article.