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Walter C. Alvarez, M.D.
JAMA. 1955;157(14):1199-1204. doi:10.1001/jama.1955.02950310025006.
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One of the commonest diseases of man is that in which, over the course of 10 or 20 years, a person is gradually pulled down by dozens or scores of thromboses of little arteries in the brain. Dr. James Kernohan,1 pathologist of the Mayo Clinic, said, on examining tissues from brains, these are among the commonest of the lesions he finds. Today most physicians know the syndrome of "the little strokes," but, I am sorry to say, the diagnosis is still often delayed and usually for two reasons 1. The patient often fails to tell the physician of a bad dizzy spell at the start of his trouble. 2. The physician is not well enough acquainted with the more bizarre and puzzling of the symptoms that can result from little strokes. Obviously, the syndrome must vary greatly with each patient, depending largely on the position in the brain of


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