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August 1927

MASSIVE CEREBRAL HEMORRHAGE: ITS RELATION TO PREEXISTING CEREBRAL SOFTENING

Author Affiliations

NEW YORK

From the Neuro-Pathological Laboratory and Neurological Service, The Mount Sinai Hospital.

Arch NeurPsych. 1927;18(2):215-239. doi:10.1001/archneurpsyc.1927.02210020059003
Abstract

It is believed that there is a series of events which precipitate the so-called cerebral apoplexy and which seem to hold a secure place in the present conception of spontaneous cerebral hemorrhage. This is well reflected in the descriptions in the textbooks of the factors and events of such vascular accidents. It is commonly held that a miliary aneurysm breaks and that from such ruptured aneurysmal vessels blood rushes suddenly out with a force that is destructive to the surrounding tissue. The tissue is torn apart, pushed aside and rapidly demolished, with the result that a large cavity filled with blood is created. Thus, the so-called hemorrhagic cyst is formed.

This conception of spontaneous cerebral hemorrhage derived its main strength from the monumental contributions of Charcot and Bouchard.1 The "miliary aneurysms," which they2 described as the almost constant changes in the vessels found in the brains of those

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