[Traumatic late apoplexy]

Abstract

"Traumatic late apoplexy" is a sudden cerebrovascular attack subsequent to traumatic cerebral lesion. According to Bollinger's concept, on which the term "traumatic late apoplexy" is based, this process was always a cerebral haemorrhage following trauma and appearing several days or weeks after the accident. In the discussions which followed after Bollinger had introduced this concept, the time sequence of this incident was fixed and the interval between trauma and apoplexy defined as occurring between the 6th day and the 8th week after the injury. However, cerebrovascular disease would have to be excluded; if this condition could not be verified with reasonable certainty, the patient would have to be at least less than 40 years of age. However, the pathological process always had to be "established" morphologically. This concept and this definition were extended a few decades later on the basis of progress made in the knowledge and treatment of cerebrovascular lesions. It was found that the pathological process need not be confined to haemorrhages only; every other traumatic cerebral lesion could be included which resulted in "apoplexy" in the clinical sense of the term with some delay after the trauma. Therefore, this article includes all modern concepts on such processes and discusses the various types of traumatic cerebral lesions which can occur in our present technological age. Reports published in literature are scrutinised and analysed more closely, and guidelines and hints are given which can be helpful in expertising work. The list of references is very extensive.