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Article
March 6, 1948

EMERGENCY TREATMENT OF APOPLEXY

Author Affiliations

Chicago

From the departments of medicine and surgery, St. Luke's Hospital.

JAMA. 1948;136(10):659-665. doi:10.1001/jama.1948.02890270001001
Abstract

Acute occlusions occurring in the peripheral vascular tree produce neurovascular phenomena which have been successfully treated for several years in our clinic by administration of antispasmodic drugs, by block of the corresponding sympathetic ganglionated chain or by embolectomy.1 This knowledge has not been generally applied to cerebral circulation, mainly because the nervous control of the cerebral vessels has been authoritatively questioned. While the vessels of the cerebral cortex react to mechanical, thermal, chemical and electric stimuli,2 and while pial arteries have been seen to go into spasm on being stretched3 or on increase of blood pressure,4 little evidence has been forthcoming from these sources that any nervous control is clinically significant. In fact, the consensus as summarized by Forbes and Cobb in a symposium on cerebral circulation5 stressed that cerebral circulation is remarkably stable, that fright, anger or other emotions do not change the vascular

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