Subarachnoid hemorrhage caused by focal, nonseptic necrosis of the vertebral artery or of its branch, the posterior inferior cerebellar artery, is an unusual occurrence. We here record our observations made on 4 elderly, generally slightly hypertensive patients who showed no evidence of endocarditis or of a general or local infectious process, who died of this condition within a few days of uncomplicated abdominal operations. Only the apparently relevant features of the histories and examinations are given.
There is a voluminous literature on the subject of subarachnoid hemorrhage; however, much of this is in reference to ruptured congenital aneurysms. Sands,1 in a recent study of subarachnoid hemorrhage, reported 120 cases and pointed out that it "is caused by (1) trauma, (2) arteriosclerotic degeneration of vessel walls, (3) septic or infectious emboli, (4) ruptured intracranial aneurysms, (5) massive cerebral hemorrhage invading the subarachnoid space, (6) intraventricular hemorrhage, (7) blood dyscrasias and
KERNOHAN JW, WOLTMAN HW. POSTOPERATIVE, FOCAL, NONSEPTIC NECROSIS OF VERTEBRAL AND CEREBELLAR ARTERIES: WITH RUPTURE AND SUBARACHNOID HEMORRHAGE. JAMA. 1943;122(17):1173–1177. doi:10.1001/jama.1943.02840340021007
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