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A case report—valuable?
Editorials
A Case Report
Surg Neurol 1987;28:403-5
405
Valuable?
that one day a surgical approach to these aneurysms would be found. 2. T o emphasize that sometimes single or double case reports are of extreme value to the literature, as they were in this instance. 3. T o call to the reader's attention that this case was reported from the Peter Bent Brigham Hospital in 1929.
Recently Dr. Paul Bucy sent me a paper that is to be published in the newly established British Journal of Neurosurgery. T h e article is entitled, "When Scandinavian N e u r o s u r g e r y was Still in Its Infancy," and is written by Bengt Ljunggren, Harald Fodstad, Kristian Kristiansen, Ib Sogaard, and Tapio Torma. I would like to congratulate the authors on this fine d o c u m e n t and the British Journal of Neurosurgery on its establishment. H o w e v e r , the primary purpose of this editorial is to call attention to another facet of this paper, a reference to one F. Albright, who was indeed Fuller Albright, one of my most brilliant professors at Harvard. We, as students, knew him as an internist skilled in all fields--he was particularly interested in m e t a b o l i s m - - a n d as the acknowledged expert on osteitis fibrosa cystica. Imagine my surprise when I located Fuller Albright's paper and found it to be a report of two cases of posterior communicating artery aneurysm. This article, in the 1929 issue of the Bulletin of theJohns Hopkins Hospital(1929;44: 215--45), includes abstracts o f 30 additional cases from the literature, each providing evidence of the signs and s y m p t o m s of an aneurysm rupturing in this specific location. It is an excellent p a p e r - - i t has many illustrations and repeatedly identifies the symptoms of subarachnoid hemorrhage from a posterior communicating artery: third nerve paralysis on the ipsilateral side, occasional relief of headache upon compression of the artery proximal to the aneurysm, and the c o m m o n rebleeding of these aneurysms with sometimes fatal consequences. Discovering this paper gives the editor the opportunity to do three things:
It is of interest to note that approximately 12 years l a t e r - - i n about 1 9 4 1 - - S o m a Weiss, newly appointed professor at the Peter Bent Brigham Hospital and at Harvard, suffered a subarachnoid hemorrhage (reported to be a middle cerebral artery aneurysm), which he himself diagnosed as an aneurysm. In light of Albright's paper (published in 1929), it is interesting that none of the consulting neurosurgeons of the day felt that there was a surgical approach to the aneurysm. The death of Soma Weiss, caused by another subarachnoid hemorrhage (probably a rebleeding of the aneurysm as mentioned above), was a great loss to medicine and to mankind. H e died of a lesion now easily recognized and treated surgically. Considering that many of the significant developments of neurosurgery over the past 20 years have come from other fields of endeavor, whether medicine, physics, chemistry, or other basic sciences, it is imperative that neurosurgeons stay abreast of the general medical literature. O u t o f the mouth of an internist may come the basic truth of inestimable value to n e u r o s u r g e r y - in this case, Fuller Albright.
1. T o praise one of his former professors, Fuller Albright, for his perception and his statement in 1929
EBEN ALEXANDER, Jr., M.D., Editor
A Case Report
Surg Neurol 1987;28:403-5
405
Valuable?
that one day a surgical approach to these aneurysms would be found. 2. T o emphasize that sometimes single or double case reports are of extreme value to the literature, as they were in this instance. 3. T o call to the reader's attention that this case was reported from the Peter Bent Brigham Hospital in 1929.
Recently Dr. Paul Bucy sent me a paper that is to be published in the newly established British Journal of Neurosurgery. T h e article is entitled, "When Scandinavian N e u r o s u r g e r y was Still in Its Infancy," and is written by Bengt Ljunggren, Harald Fodstad, Kristian Kristiansen, Ib Sogaard, and Tapio Torma. I would like to congratulate the authors on this fine d o c u m e n t and the British Journal of Neurosurgery on its establishment. H o w e v e r , the primary purpose of this editorial is to call attention to another facet of this paper, a reference to one F. Albright, who was indeed Fuller Albright, one of my most brilliant professors at Harvard. We, as students, knew him as an internist skilled in all fields--he was particularly interested in m e t a b o l i s m - - a n d as the acknowledged expert on osteitis fibrosa cystica. Imagine my surprise when I located Fuller Albright's paper and found it to be a report of two cases of posterior communicating artery aneurysm. This article, in the 1929 issue of the Bulletin of theJohns Hopkins Hospital(1929;44: 215--45), includes abstracts o f 30 additional cases from the literature, each providing evidence of the signs and s y m p t o m s of an aneurysm rupturing in this specific location. It is an excellent p a p e r - - i t has many illustrations and repeatedly identifies the symptoms of subarachnoid hemorrhage from a posterior communicating artery: third nerve paralysis on the ipsilateral side, occasional relief of headache upon compression of the artery proximal to the aneurysm, and the c o m m o n rebleeding of these aneurysms with sometimes fatal consequences. Discovering this paper gives the editor the opportunity to do three things:
It is of interest to note that approximately 12 years l a t e r - - i n about 1 9 4 1 - - S o m a Weiss, newly appointed professor at the Peter Bent Brigham Hospital and at Harvard, suffered a subarachnoid hemorrhage (reported to be a middle cerebral artery aneurysm), which he himself diagnosed as an aneurysm. In light of Albright's paper (published in 1929), it is interesting that none of the consulting neurosurgeons of the day felt that there was a surgical approach to the aneurysm. The death of Soma Weiss, caused by another subarachnoid hemorrhage (probably a rebleeding of the aneurysm as mentioned above), was a great loss to medicine and to mankind. H e died of a lesion now easily recognized and treated surgically. Considering that many of the significant developments of neurosurgery over the past 20 years have come from other fields of endeavor, whether medicine, physics, chemistry, or other basic sciences, it is imperative that neurosurgeons stay abreast of the general medical literature. O u t o f the mouth of an internist may come the basic truth of inestimable value to n e u r o s u r g e r y - in this case, Fuller Albright.
1. T o praise one of his former professors, Fuller Albright, for his perception and his statement in 1929
EBEN ALEXANDER, Jr., M.D., Editor