Rose F C
London Neurological Center, United Kingdom.
J Hist Neurosci. 1997 Aug;6(2):154-80. doi: 10.1080/09647049709525700.
The history of cerebral trauma is a large subject and this overview is an attempt to summarise the main trends of understanding and management over the millenia. Although beginning with anthropological evidence, papyrology and Homeric times, the main impetus for its scientific study began with Hippocrates, but little progress was made until the Salernitan period. Because the ancients believed it was the fractured bone and not the underlying neurological status that mattered, and determined whether an operation was to be performed, the classification of head injuries was based on the types of skull fracture and not the underlying neurological damage. Only in recent centuries was it realised that it was not skull fractures that were important but the brain lesion. Further improvement in management occurred during warring periods but the lessons learned were not passed on, although mortality from military wounds has steadily declined. Since only a small percentage of head injuries require surgery, consideration should be given to reserve the time and skills of the neurosurgeon to those cases requiring his expertise; this would require that the preliminary care should be undertaken by physicians with a specific interest in this field.
脑外伤的历史是一个庞大的主题，本概述旨在总结数千年来对其理解和治疗的主要趋势。虽然从人类学证据、纸莎草文献和荷马时代开始，但对其进行科学研究的主要推动力始于希波克拉底，但直到萨勒诺时期才取得了一些进展。由于古人认为重要的是骨折的骨头而不是潜在的神经状况，并且据此决定是否进行手术，所以头部损伤的分类是基于颅骨骨折的类型而不是潜在的神经损伤。直到最近几个世纪，人们才意识到重要的不是颅骨骨折而是脑损伤。在战争时期治疗方法有了进一步改进，但所吸取的经验教训没有得到传承，尽管军事创伤的死亡率一直在稳步下降。由于只有一小部分头部损伤需要手术，所以应该考虑将神经外科医生的时间和技能保留给那些需要其专业知识的病例；这就要求由对该领域有特殊兴趣的医生进行初步护理。
