Abstract SPONTANEOUS intracranial hemorrhage is a condition most frequently found in adults. It does occur in children, however, and, when present, the problems of diagnosis and treatment are, with a few exceptions, very similar to those in adults. This report concerns spontaneous intracranial hemorrhage in eight children, 15 years of age or younger. All had proved hemorrhage by operation. Two deaths and six recoveries resulted. Four of these children were treated at the University of Minnesota Hospitals and four at other hospitals. The commonest cause of spontaneous intracranial hemorrhage in children is a vascular anomaly, either aneurysmal or angiomatous. Hemorrhage from toxins, infectious diseases, blood dyscrasias, and tumors is rare. It is the widespread opinion that aneurysms and other vascular anomalies of the brain are congenital in origin. Dandy1 supported this view, and, more specifically, he thought that aneurysms could develop at sites where embryonic vessels or vascular buds had developed References 1. Dandy, W. E.: Venous Abnormalities and Angiomas of the Brain , Arch. Surg. 17:715-793 ( (Nov.) ) 1928Crossref 2. Arteriovenous Aneurysm of the Brain , Dandy Arch. Surg. 17:190-243 ( (Aug.) ) 1928Crossref 3. Intracranial Arterial Aneurysms , Ithaca, N. Y., Comstock Publishing Co., Inc., 1944. 4. Sugar, O.: Symposium: Intracranial Vascular Abnormalities: Pathological Anatomy and Angiography of Intracranial Vascular Anomalies , J. Neurosurg. 8:3-22 ( (Jan.) ) 1951.Crossref 5. Bassett, R. C.: Symposium: Intracranial Vascular Abnormalities: Surgical Experiences with Arteriovenous Anomalies of the Brain , J. Neurosurg. 8:59-74 ( (Jan.) ) 1951Crossref 6. Forbus, W. D.: On the Origin of Miliary Aneurysms of the Superficial Cerebral Arteries , Bull. Johns Hopkins Hosp. 47:239-284 ( (Nov.) ) 1930. 7. Eppinger, H.: Pathogenesis (Histogenesis und Aetiologie) der Aneurysmen einschliesslich des Aneurysma equi verminosum , Arch. klin. Chir. 35:1-563, 1887. 8. McDonald, C. A., and Korb, M.: Intracranial Aneurysms , Arch. Neurol. & Psychiat. 42:298-328 ( (Aug.) ) 1939. 9. Sands, I. J.: Diagnosis and Management of Subarachnoid Hemorrhage , Arch. Neurol. & Psychiat. 46: 973-1005 ( (Dec.) ) 1941. 10. Baker, T. W., and Shelden, W. D.: Coarctation of the Aorta with Intermittent Leakage of a Congenital Cerebral Aneurysm: Report of Case , Am. J. M. Sc. 191:626-633 ( (May) ) 1936. 11. Strassmann, G., cited by McDonald and Korb.6 12. Bagley, C., Jr.: Blood in Cerebrospinal Fluid: Resultant Functional and Organic Alterations in Central Nervous System: Experimental Data, (July) 1928 13. Spontaneous Cerebral Hemorrhage: Discussion of 4 Types with Surgical Considerations , Arch. Neurol. & Psychiat. 27:1133-1174 ( (May) ) 1932. 14. Cushing, H., and Bailey, P.: Tumors Arising from the Blood Vessels of the Brain: Angiomatous Malformations and Hemangioblastomas , Springfield, Ill., Charles C Thomas, Publisher, 1928. 15. Jaeger, R.: Aneurysm of Intracranial Carotid Artery: Syndrome of Frontal Headache with Oculomotor Nerve Paralysis , J. A. M. A. 142:304-310 ( (Feb. 4) ) 1950. 16. Richardson, J. C., and Hyland, H. H.: Intracranial Aneurysms: Clinical and Pathological Study of Subarachnoid and Intracerebral Haemorrhage Caused by Berry Aneurysms , Medicine 20:1-83 ( (Feb.) ) 1941. 17. Strauss, I.; Globus, J. H., and Ginsburg, S. W.: Spontaneous Subarachnoid Hemorrhage: Its Relation to Aneurysms of Cerebral Blood Vessels , Arch. Neurol. & Psychiat. 27:1080-1132 ( (May) ) 1932. 18. Kahan, A.: Spontaneous Subarachnoid Hemorrhage in Children , Brit. M. J. 1:567 ( (March 17) ) 1951. 19. Miller, H. G.: Spontaneous Subarachnoid Haemorrhage in Children , Arch. Dis. Childhood 13:258-263 ( (Sept.) ) 1938. 20. Ramsay, M. L.: Subarachnoid Haemorrhage in a Child , Brit. M. J. 1:1070 ( (June 20) ) 1931. 21. Sachs, B.: Apoplexy , Bull. New York Acad. Med. 4:1250-1257 ( (Dec.) ) 1928. 22. Mount, L. A.: Treatment of Spontaneous Subarachnoid Hemorrhage , J. A. M. A. 146:693-697 ( (June 23) ) 1951. 23. Falconer, M. A.: Surgical Treatment of Spontaneous Subarachnoid Haemorrhage: Preliminary Report , Brit. M. J. 1:809-813 ( (April 8) ) 1950. 24. Hamby, W. B.: Spontaneous Subarachnoid Hemorrhage of Aneurysmal Origin: Factors Influencing Prognosis , J. A. M. A. 136:522-528 ( (Feb. 21) ) 1948. 25. Norlen, G.: Arteriovenous Aneurysms of the Brain: Report of 10 Cases of Total Removal of Lesion , J. Neurosurg. 6:475-494 ( (Nov.) ) 1949.Crossref 26. Olivecrona, H., and Riives, J.: Arteriovenous Aneurysms of the Brain: Their Diagnosis and Treatment , Arch. Neurol & Psychiat. 59:567-602 ( (May) ) 1948. 27. Olivecrona, H.: Arteriovenous Aneurysms in Brain , Nord. med. 41:843-886 ( (May 13) ) 1949 28. abstracted, J. A. M. A. 141:878 ( (Nov. 19) ) 1949. 29. Penfield, W.: Operative Treatment of Spontaneous Intracerebral Haemorrhage , Canad. M. A. J. 28:369-372 ( (April) ) 1933. 30. Pilcher, C.: Subcortical Hematoma: Surgical Treatment, with Report of 8 Cases , Arch. Neurol. & Psychiat. 46:416-430 ( (Sept.) ) 1941. 31. Pilcher, C.; Meachem, W. F., and Cobb, C. A.: Surgical Treatment of Intracranial Angiomatous Malformations , Surgery 28:342-349 ( (Aug.) ) 1950. 32. Poppen, J. L.: Symposium: Intracranial Vascular Abnormalities: Specific Treatment of Intracranial Aneurysms: Experiences with 143 Surgically Treated Patients , J. Neurosurg. 8: 75-102 ( (Jan.) ) 1951. 33. Schwartz, H. G.: Subarachnoid Hemorrhage and Intracranial Aneurysm , Postgrad. Med. 4:307-314 ( (Oct.) ) 1948. 34. Swain, R. D.: Surgical Treatment of Certain Intracranial Arterial Aneurysms , S. Clin. North America 28:396-404 ( (April) ) 1948. 35. Gull, W.: Aneurism of Cerebral Vessels: 6 Cases , Guy's Hosp. Rep. 5:281-304 (Series 3) 1859.
A.M.A. Archives Surgery – American Medical Association
Published: Apr 1, 1953
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