Lawrence of Arabia, Sir Hugh Cairns, and the origin of motorcycle helmets.

When Colonel T.E. Lawrence ("Lawrence of Arabia") was fatally injured in a motorcycle accident in May 1935, one of the several doctors attending him was a young neurosurgeon, Hugh Cairns. He was moved by the tragedy in a way that was to have far-reaching consequences. At the beginning of the Second World War, he highlighted the unnecessary loss of life among army motorcycle dispatch riders as a result of head injuries. His research concluded that the adoption of crash helmets as standard by both military and civilian motorcyclists would result in considerable saving of life. It was 32 years later, however, that motorcycle crash helmets were made compulsory in the United Kingdom. As a consequence of treating T.E. Lawrence and through his research at Oxford, Sir Hugh Cairns' work largely pioneered legislation for protective headgear by motorcyclists and subsequently in the workplace and for many sports worldwide. Over subsequent decades, this has saved countless lives.

Treatment of intracerebral hematomas caused by aneurysm rupture: coil placement followed by clot evacuation.

OBJECT: The aim of this study was to evaluate the efficacy of a treatment combination of coil embolization and clot evacuation in patients presenting with an intracerebral hematoma (ICH) caused by the rupture of an aneurysm. METHODS: Twenty-seven patients were prospectively recruited in this study between 1996 and 2000. Endovascular treatment of the putative ruptured aneurysm was performed as soon as practical after diagnosis and before surgical evacuation of the ICH. The Glasgow Outcome Scale (GOS) was used during follow up. Despite admission World Federation of Neurosurgical Societies grades of IV or V in 25 patients (92%), 13 (48%) recovered well with GOS scores of 1 or 2, whereas six patients (21%) died. CONCLUSIONS: The combined result of a favorable outcome in 48% of the patients and a mortality rate of 21% indicates that this treatment may be a valuable alternative for this patient group and warrants further study.