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May 1951

CEREBROVASCULAR ACCIDENTSSurgical Management with Particular Reference to Massive Intracranial Hemorrhage

Author Affiliations

From the Department of Surgery, Wayne University, and the Department of Neuro-Surgery, Grace Hospital.

AMA Arch Surg. 1951;62(5):724-736. doi:10.1001/archsurg.1951.01250030734014

CEREBROVASCULAR disease ranks third as a cause for death in the United States. In 1949, 340,000 victims died of cerebrovascular accidents. This tremendous mortality does not indicate the morbidity of the disease, since many times this number were partially and totally disabled.

The manifestations of cerebrovascular disease have been described for centuries. Cerebral hemorrhage was early and clearly recognized, while embolism and thrombosis were not known until the early part of the nineteenth century. The concept that hemorrhage in the brain disturbs the normal flow of animal spirits into the organs of sense and motion resulting in hemiplegia and unconsciousness was a theory inherited from Galen1 in the second century. Wepfer,2 in 1658, gave an excellent description of hemorrhage in the brain in his book on apoplexia. He also described accurately the blood vessels at the base of the brain, two decades later called the circle of Willis.

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