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February 1965

Acute Neurogenic Activation of Chronic Duodenal Ulcers: Hemorrhage or Perforation Following Acute Cerebrovascular Accidents

Author Affiliations


From the Departments of Nervous Diseases and Surgery "A," Hadassah University Hospital and the Hebrew University-Hadassah Medical School. Associate Professor of Neurology (Dr. Feldman); Lecturer in Surgery (Dr. Luttwak); Assistant in Department of Nervous Diseases (Dr. Carmon).

Arch Intern Med. 1965;115(2):140-144. doi:10.1001/archinte.1965.03860140020005

THE ASSOCIATION of acute gastrointestinal lesions with brain pathology has been known for many years.1 It is only more recently, since the clinical observations of Cushing2 and with the elucidation of the central control of gastrointestinal functions,3,4 that this association has assumed a greater clinical importance. Acute neurogenic gastrointestinal ulceration and hemorrhage have been described as complications of a variety of traumatic, inflammatory, and neoplastic lesions of the central nervous system, as well as following intracranial operations and acute cerebrovascular accidents.5-11 These complications are usually of grave clinical significance, in view of the associated neurological disorder, the nature and multiplicity of the gastrointestinal lesions, and the possible presence of gastromalacia. Every effort, therefore, is made to treat the patients conservatively, and surgery is usually only undertaken as a last resort. This is by itself a dangerous procedure under such circumstances and usually fails to change the