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January 16, 1967

Localized Dissecting Hemorrhage and ArteritisRenal and Cerebral Manifestations

Author Affiliations

From the Department of Pathology, Tufts-New England Medical Center, Boston.

JAMA. 1967;199(3):219-220. doi:10.1001/jama.1967.03120030123030

PERIARTERITIS NODOSA has been gradually redefined over the past hundred years so as to become but a phase in a broad spectrum of vascular disease in which the individual members tend to lose their identity. To most people, however, it represents a widely disseminated panarteritis with ischemic rather than primarily hemorrhagic manifestations which are characteristically not isolated.

This case is presented primarily (1) because it proves distinctive and variant in its histological pattern, (2) for the isolated localization of its principal lesions, and (3) for its totally deceptive manifestations mimicking a ruptured aneurysm of a cerebral artery.

Report of a Case  The patient, a 26-year-old white woman, had been known to have hypertension for the last ten years and migraine headaches for many more. This last illness began suddenly with severe headache followed by unresponsiveness, nuchal rigidity, and grossly bloody spinal fluid. Her temperature was 103 F (39.4 C) on