Title: N——, Presley W.

Source text: Surgeon General Joseph K. Barnes, United States Army, The Medical and Surgical History of the War of the Rebellion. (1861–65.), Part 1, Volume 2 (Washington, D.C.: Government Printing Office, 1870), 248.

Keywords:wounds and injuries of the headfatal cases of gunshot fractures of the skull treated by the removal or elevation of fragmentsremoval of fragments after gunshot fractures of the skullcomminuted both tables of temporal bone above mastoid processbrain abscess in left ventricle

Civil War Washington ID: med.d1e16315

TEI/XML: med.d1e16315.xml

CASE.—Sergeant Presley W. N——, Co. C, 1st Ohio Volunteer Cavalry, aged 24 years, was wounded near Culpeper, Virginia, September 13th, 1863, by a musket ball, which comminuted both tables of the left temporal bone two inches above the mastoid process. He was conveyed to Washington, and admitted into Armory Square Hospital onthe 15th, where simple dressings were applied to the wound. The head symptoms were very slight until October 7th; from that time he gradually grew worse. On the 17th, nausea and vomiting supervened. An incision was made over the cicatrix by Surgeon D. W. Bliss, U. S. V., and several small spiculæ of bone were removed, which, however, afforded no relief, and the vomiting, with increased pain in head, continued. The patient sank rapidly, and died on the 20th. The post-mortem examination revealed the vessels of the membranes and of the brain in a high state of congestion. An abscess was found in the left ventricle, which communicated with the external wound, and contained an ounce of dark, greenish pus. The substance of the brain in the vicinity of the abscess was softened. Communication existed between the external wound and the abscess, which was filled with spiculæ. The pathological specimen is represented in the adjacent wood-cut. The edges of the fracture in the cranium are somewhat rounded, exhibiting evidence of attempts at repair. The specimen and history were contributed by Surgeon D. W. Bliss, U. S. V.

FIG. 118.—Segment of left temporal bone, from which fragments have been removed. Spec. 1824, Sect. I, A. M. M. [Two-thirds size.]