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To the Editor:—
In The Journal, September 27, Judah Marmor and M. R. Sapirstein reported a case of "Bilateral Thrombosis of Anterior Cerebral Artery Following Stimulation of a Hyperactive Carotid Sinus."The authors gave the blood count of this patient as hemoglobin 114 per cent, red cells 6,100,000 and leukocytes 14,000 with a normal differential. The hematocrit test, however, was within normal limits.They conclude that "the slowing of the pulse and the fall in blood pressure produced by stimulation of the carotid sinus was a contributory factor in prematurely precipitating the cerebral thrombosis... in elderly persons with evidence of advanced arteriosclerosis, cerebral as well as myocardial. It may well be that carotid sinus stimulation is not entirely without danger in such persons."While their conclusion is logical, I think that they should also have stressed the probability of the polycythemia, although not vera, having been a predisposing factor for
Feldman L. BILATERAL THROMBOSIS OF ANTERIOR CEREBRAL ARTERY. JAMA. 1941;117(21):1806-1807. doi:10.1001/jama.1941.02820470054025