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December 1969

The Hypertensive Vascular Crisis—An Experimental Study.

Arch Neurol. 1969;21(6):671-672. doi:10.1001/archneur.1969.00480180127018

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In this rather brief but very well written monograph the author develops his views on the pathophysiology of the malignant phase of hypertension and presented an account of several investigations in rats rendered hypertensive by renal artery construction. His observations on the behavior of the cerebral vasculature in these animals and of the associated "hypertensive encephalopathy" will be of particular interest to the neurologist. These include the provocative observation that x-rays delivered to the brain in modest dosages can precipitate cerebral hemorrhages in the hypertensive rat.

The author believes that the essential lesion of hypertension—focal necrosis of the arterial wall—occurs in zones of arterial dilatation and results from overstretching and tearing of the media muscle fibers. Ischemia, edema, and necrosis of the tissue supplied results. To put it simply, the vascular crises of malignant hypertension occur when the uneven muscular tube that is the arterial system can no longer contain a

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