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THE PATHOGENESIS OF SPONTANEOUS CEREBRAL HEMORRHAGE

JAMA. 1909;LIII(21):1745. doi:10.1001/jama.1909.02550210042006.
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Since the classical article of Charcot and Bouchard in 1868 it has been common knowledge that cerebral hemorrhage is associated with the presence of minute aneurisms in the smaller, intracerebral arteries, and that the hemorrhage is presumably the result of the giving way of these aneurismal dilatations. In sixty cases of cerebral apoplexy these authors found miliary aneurisms, from two to hundreds in each brain, arising on arteries of a diameter of 0.03 to 0.25 millimeter, and established by their research the significance of the aneurisms in the pathogenesis of cerebral hemorrhage. Earlier investigations, however, had already pointed out the existence of these aneurisms, Morgagni himself in 1761 having stated that rupture of the cerebral arteries was a consequence of their widening, whereby the walls became thinned; but it was not until 1859 that the actual source of a hemorrhagic extravasation in the brain was detected in a ruptured miliary

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