A case of basilar artery aneurysm rupture from 1836

Lessons in clinical observation and the natural history of the disease

Andreas K. Demetriades, Takashi Horiguchi, James Tait Goodrich, Takeshi Kawase

Research output: Contribution to journalArticle

Abstract

Although credit is given to Sir William Gull for highlighting the clinical picture of subarachnoid hemorrhage in 1859, we discuss a case presented by Mr. Egerton A. Jennings, Fellow of the Linnaean Society, published 23 years earlier in the 1836 edition of the Transactions of the Provincial Medical and Surgical Association. This case, probably the first reported in the English language of a basilar aneurysm rupture, is of medico-historical interest. Jennings provided a remarkably accurate and detailed description of the patient, who experienced coma as a result of the severity of subarachnoid hemorrhage. The detailed clinical observations on initial assessment and the description of the patient's deterioration to the time of death are a succinct representation of the natural history of this disease. The author's discussion provides evidence of a philosophy committed to medical education and progress at the time based on principles of rational observation, meticulous clinical acumen, insight into experimental physiology, and the awareness of ethical boundaries. In provincial 1836 England, similar to most of Europe, cerebral localization was elementary. Nonetheless, this case report highlights the attempt at linking structure to function by means of observation on the effects of lesioning. It provides evidence of an established thought process already in progress in England in the 19th century. It is characteristic that this thought process came from a surgical practitioner. The cultivation of practical observation in British surgical culture would allow the late 19th century surgeon scientists to match the contributions of British neurologists with landmark steps in the development and establishment of neurosurgery.

Original languageEnglish (US)
Pages (from-to)902-905
Number of pages4
JournalWorld Neurosurgery
Volume82
Issue number5
DOIs
StatePublished - Nov 1 2014

Fingerprint

Intracranial Aneurysm
Subarachnoid Hemorrhage
England
Rupture
Observation
Charadriiformes
Neurosurgery
Coma
Medical Education
Aneurysm
Language
Surgeons
Neurologists

Keywords

  • Basilar artery aneurysm
  • Early 19th century cerebral localization
  • Early 19th century neurosurgery
  • History of neurosurgery
  • Natural history of subarachnoid hemorrhage
  • Subarachnoid hemorrhage

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery
  • Medicine(all)

Cite this

A case of basilar artery aneurysm rupture from 1836 : Lessons in clinical observation and the natural history of the disease. / Demetriades, Andreas K.; Horiguchi, Takashi; Goodrich, James Tait; Kawase, Takeshi.

In: World Neurosurgery, Vol. 82, No. 5, 01.11.2014, p. 902-905.

Research output: Contribution to journalArticle

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