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Updated: June 28, 2025
#Intracranial aneurysm# involves the internal carotid and its branches, or the basilar artery, and appears to be more frequently associated with syphilis and with valvular disease of the heart than are external aneurysms. It gives rise to symptoms similar to those of other intracranial tumours, and there is sometimes a loud murmur. It usually proves fatal by rupture, and intracranial hæmorrhage.
This was actually his last work, for a month later, on the 28th of October, 1764, having returned in weak health from Chiswick to his house in Leicester Fields, he died suddenly of an aneurysm on his chest. If genius fire thee, reader, stay; If nature touch thee, drop a tear; If neither move thee, turn away, For Hogarth's honoured dust lies here."
These factors probably explain the comparative frequency of aneurysm in those who follow such arduous occupations as soldiers, sailors, dock-labourers, and navvies. In these classes the condition usually manifests itself between the ages of thirty and fifty that is, when the vessels are beginning to degenerate, although the heart is still vigorous and the men are hard at work.
When the bleeding takes place into the cellular tissue, the aneurysm is said to become diffused, and the extravasated blood spreads widely through the tissues, exerting great pressure on the surrounding structures. The clinical features associated with rupture are sudden and severe pain in the part, and the patient becomes pale, cold, and faint.
Experience has shown that this method possesses great advantages, and that it has none of the disadvantages which were formerly supposed to attend it. Saccular dilatations of arteries which are the result of cuts or other injuries are treated by tying the vessel above and below, and by dissecting out the aneurysm.
The fact that compression of the vessel does not affect the size and tension of these fluid swellings is useful in distinguishing them from aneurysm. Treatment. Digital compression of the vessel against the transverse process of the sixth cervical vertebra the "carotid tubercle" has been successfully employed in the treatment of aneurysm near the bifurcation.
The essential feature of a traumatic aneurysm is that it is produced by some form of injury which divides all the coats of the artery. The walls of the injured vessel are presumably healthy, but they form no part of the sac of the aneurysm. The sac consists of the condensed and thickened tissues around the artery.
#Brachial Neuralgia.# The pain is definitely located in the distribution of one of the branches or nerve roots, is often intermittent, and is usually associated with tingling and disturbance of tactile sensation. The root of the neck should be examined to exclude pressure as the cause of the pain by a cervical rib, a tumour, or an aneurysm.
They consist in a pulsatile swelling sometimes in the supra-sternal notch, but usually towards the right side of the sternum with an increased area of dulness on percussion. With the X-rays a dark shadow is seen corresponding to the sac. Pain is usually a prominent symptom, and is largely referable to the pressure of the aneurysm on the vertebræ or the sternum, causing erosion of these bones.
The conditions most likely to be mistaken for it are a soft, rapidly growing sarcoma, and a normal artery raised on a cervical rib. On account of the relations of the artery and of its branches, treatment is attended with greater difficulty and danger in subclavian than in almost any other form of external aneurysm.
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