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February 17, 1945


JAMA. 1945;127(7):384-389. doi:10.1001/jama.1945.02860070016005

Symptoms referable to the nervous system which precede the onset of cerebral hemorrhage and the association of apoplexy with necropsy evidence of left ventricular hypertrophy have been recognized since the times of Galen and Morgagni.1 Lidell2 in 1873 described in detail transient paresthesia, aphasia, temporary motor paralysis, vertigo and syncope, memory defects and blind spots, as frequent prodromes of fatal apoplexy. When arterial hypertension was recognized, it soon became apparent that the vast majority of such accidents were due to this disease (Lippman3 and Baer4), and most contemporary discussions of essential hypertension5 mention that signs and symptoms of impaired cerebral circulation can be the forerunners of cerebral hemorrhage. However, possibly because they have been erroneously considered to be manifestations of the comparatively benign hypertensive encephalopathy described by Fishberg and Oppenheimer,6 the value of these findings seems to have been generally lost sight of, so