J.Jpn. Surg. Soc.. 55(8): 879-885, 1954

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Original article

HEAD INJURIES AND TRAUMATIC SHOCK

The author discussed, here, presence of shock clinically in cases of trauma including trauma of the head, chest wall, abdomen and extremities and their combined cases, in view point of the objective indicators of shock that is to say the reduction of carbon dioxide and increase of amino acid nitrogen in arterial blood, which Prof. Shimada of Keio University had advocated.
1. In cases of intensive trauma (except for head trauma), they showed clear shock findings : remarkable decrease of carbon dioxide and increase of amino acid nitrogen. At the time of traumatic shock no haemoconcentration was noted.
2. In head traumas, including brain concussion, contusion, intracanial haemorrhage accompanied laceration of the scalp and fracture of the skull, the indicators of shock showed very few changes, unless they had such severe external haemorrhages as to cause haemorrhagic shock. Consequently shock seldom occurred at such time. It might be reasonably justified that the symptomes of head trauma were different from that of traumatic shock produced by general trauma.
3. The occurrence of shock in cases of head trauma combined with general trauma was dicided by the severity of the latter. (author's abstract)

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