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RECURRENT CEREBRAL EMBOLISM: A Cause of Chronic Organic Brain Disease

RECURRENT CEREBRAL EMBOLISM: A Cause of Chronic Organic Brain Disease Abstract THE TERM "cerebral embolism" has in the course of time acquired a fixed clinical meaning; in its usual connotation this diagnosis portrays an episode of sudden onset, often of rapid fatal termination. This conception of embolic disease of the brain, although deeply rooted in medical thinking, is inadequate. There is mounting indication that often cerebral embolism does not manifest itself as an acute process; this syndrome may, in fact, pursue a subtle, recurrent chronic course ultimately leading to progressive crippling of cerebral function. Cerebral embolism is usually thought of clinically as an acute catastrophic neurological complication occurring in patients with known active cardiac disease. All too familiar is the clinical picture of acute cerebral embolism: A patient with known myocardial infarction, convalescing favorably, is suddenly rendered hemiplegic. However, in some instances the onset of symptoms is insidious and slow. In patients who prove to have cerebral embolism often the cardiac References 1. References 9, 10, and 11. 2. References 9 and 11. 3. Garvin, C. F.: Mural Thrombi in the Heart , Am. Heart J. 21:713, 1941.Crossref 4. Levine, S. A.: Clinical Heart Disease , Ed. 3, Philadelphia, W. B. Saunders Company, 1945. 5. Hyman, A. S., and Parsonnet, A. E.: The Failing Heart of Middle Life , Philadelphia, F. A. Davis Company, 1932. 6. Connor, L. A., and Holt, E.: Subsequent Course and Prognosis in Coronary Thrombosis , Am. Heart J. 5:705, 1930.Crossref 7. Harris, A. W., and Levine, S. A.: Cerebral Embolism in Mitral Stenosis , Ann. Int. Med. 15: 637, 1941.Crossref 8. Friedberg, C. K.: Diseases of the Heart , Philadelphia, W. B. Saunders Company, 1949. 9. Foley, W. T., and Wright, I. S.: M. Clin. North America 34:909, 1950. 10. Toone, E. C.: Cerebral Manifestations of Bacterial Endocarditis , Ann. Int. Med. 14:1551, 1941.Crossref 11. Gross, L., and Friedberg, C. K.: Nonbacterial Thrombotic Endocarditis , Arch. Int. Med. 58:620, 1936.Crossref 12. Angrist, A. A., and Marquiss, J.: Changing Morphologic Picture of Endocarditis at Necropsy Since the Advent of Chemotherapy and Antibiotic Agents , Am. J. Path. 29:594, 1953. 13. Allen, A. C., and Sirota, J. H.: Morphogenesis and Significance of Degenerative Verrucal Endocarditis (Terminal Endocarditis, Endocarditis Simplex, Non-Bacterial Thrombotic Endocarditis) , Am. J. Path. 20:1025, 1944. 14. Heathfield, K. W. C., and Jewesburg, E. C. O.: Supranuclear Bulbar Palsy (Pseudobulbar Palsy) in Mitral Stenosis , Brit. M. J. 2:1196, 1950.Crossref 15. Manguel, M.: Enfermedad mitral reumática con embolias cerebrales multiples , Día méd. 20: 1501, 1948. 16. Mezei, B.: Psychose bei embolischem Parkinsonismus , Psychiat.-neurol. Wchnschr. 42:204, 1940. 17. Thompson, G. N.: Cerebellar Embolism , Bull. Los Angeles Neurol. Soc. 9:140, 1944. 18. Leavitt, F. H.: Multiple Cerebral Emboli , Arch. Neurol. & Psychiat. 34:682, 1935. 19. Hellerstein, H. K., and Martin, J. W.: Incidence of Thromboembolic Lesions Accompanying Myocardial Infarction , Am. Heart J. 33:443, 1947. 20. Wright, I. S., and Foley, W. T.: Use of Anticoagulants in Treatment of Heart Disease , Am. J. Med. 3:718, 1947. 21. Boyd, J. L., and Werblow, S. C.: Coronary Thrombosis Without Pain , Am. J. M. Sc. 194:814, 1937. 22. Dozzi, D. L.: Cerebral Embolism as a Complication of Coronary Thrombosis , Am. J. M. Sc. 194:824, 1937. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives of Neurology & Psychiatry American Medical Association

RECURRENT CEREBRAL EMBOLISM: A Cause of Chronic Organic Brain Disease

A.M.A. Archives of Neurology & Psychiatry , Volume 73 (2) – Feb 1, 1955

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Publisher
American Medical Association
Copyright
Copyright © 1955 American Medical Association. All Rights Reserved.
ISSN
0096-6886
DOI
10.1001/archneurpsyc.1955.02330080051013
Publisher site
See Article on Publisher Site

Abstract

Abstract THE TERM "cerebral embolism" has in the course of time acquired a fixed clinical meaning; in its usual connotation this diagnosis portrays an episode of sudden onset, often of rapid fatal termination. This conception of embolic disease of the brain, although deeply rooted in medical thinking, is inadequate. There is mounting indication that often cerebral embolism does not manifest itself as an acute process; this syndrome may, in fact, pursue a subtle, recurrent chronic course ultimately leading to progressive crippling of cerebral function. Cerebral embolism is usually thought of clinically as an acute catastrophic neurological complication occurring in patients with known active cardiac disease. All too familiar is the clinical picture of acute cerebral embolism: A patient with known myocardial infarction, convalescing favorably, is suddenly rendered hemiplegic. However, in some instances the onset of symptoms is insidious and slow. In patients who prove to have cerebral embolism often the cardiac References 1. References 9, 10, and 11. 2. References 9 and 11. 3. Garvin, C. F.: Mural Thrombi in the Heart , Am. Heart J. 21:713, 1941.Crossref 4. Levine, S. A.: Clinical Heart Disease , Ed. 3, Philadelphia, W. B. Saunders Company, 1945. 5. Hyman, A. S., and Parsonnet, A. E.: The Failing Heart of Middle Life , Philadelphia, F. A. Davis Company, 1932. 6. Connor, L. A., and Holt, E.: Subsequent Course and Prognosis in Coronary Thrombosis , Am. Heart J. 5:705, 1930.Crossref 7. Harris, A. W., and Levine, S. A.: Cerebral Embolism in Mitral Stenosis , Ann. Int. Med. 15: 637, 1941.Crossref 8. Friedberg, C. K.: Diseases of the Heart , Philadelphia, W. B. Saunders Company, 1949. 9. Foley, W. T., and Wright, I. S.: M. Clin. North America 34:909, 1950. 10. Toone, E. C.: Cerebral Manifestations of Bacterial Endocarditis , Ann. Int. Med. 14:1551, 1941.Crossref 11. Gross, L., and Friedberg, C. K.: Nonbacterial Thrombotic Endocarditis , Arch. Int. Med. 58:620, 1936.Crossref 12. Angrist, A. A., and Marquiss, J.: Changing Morphologic Picture of Endocarditis at Necropsy Since the Advent of Chemotherapy and Antibiotic Agents , Am. J. Path. 29:594, 1953. 13. Allen, A. C., and Sirota, J. H.: Morphogenesis and Significance of Degenerative Verrucal Endocarditis (Terminal Endocarditis, Endocarditis Simplex, Non-Bacterial Thrombotic Endocarditis) , Am. J. Path. 20:1025, 1944. 14. Heathfield, K. W. C., and Jewesburg, E. C. O.: Supranuclear Bulbar Palsy (Pseudobulbar Palsy) in Mitral Stenosis , Brit. M. J. 2:1196, 1950.Crossref 15. Manguel, M.: Enfermedad mitral reumática con embolias cerebrales multiples , Día méd. 20: 1501, 1948. 16. Mezei, B.: Psychose bei embolischem Parkinsonismus , Psychiat.-neurol. Wchnschr. 42:204, 1940. 17. Thompson, G. N.: Cerebellar Embolism , Bull. Los Angeles Neurol. Soc. 9:140, 1944. 18. Leavitt, F. H.: Multiple Cerebral Emboli , Arch. Neurol. & Psychiat. 34:682, 1935. 19. Hellerstein, H. K., and Martin, J. W.: Incidence of Thromboembolic Lesions Accompanying Myocardial Infarction , Am. Heart J. 33:443, 1947. 20. Wright, I. S., and Foley, W. T.: Use of Anticoagulants in Treatment of Heart Disease , Am. J. Med. 3:718, 1947. 21. Boyd, J. L., and Werblow, S. C.: Coronary Thrombosis Without Pain , Am. J. M. Sc. 194:814, 1937. 22. Dozzi, D. L.: Cerebral Embolism as a Complication of Coronary Thrombosis , Am. J. M. Sc. 194:824, 1937.

Journal

A.M.A. Archives of Neurology & PsychiatryAmerican Medical Association

Published: Feb 1, 1955

References