A study of eight surgically treated cases of spontaneous sub-cortical haematoma.

It is almost half a century since Cushing (1903) reported the first surgical removal of an intracerebral blood clot. His report was followed six years later by a similar account by Russell and Sargent (1909). And yet, apart from sporadic but valuable reports (Penfield, 1933), the neurosurgical era of the treatment of intracerebral haemorrhages may be said only to begin with Craig and Adson's paper (1936) on nine cases. Since then there has been an increasing number of publications about the surgical possibilities in such cases and about the puzzling problems of aetiology and pathogenesis. Jewesbury (1947) reviewed the English literature and added one case of spontaneous intracerebral bleeding cured by operation. From the nonEnglish-speaking countries we should like to mention the efforts made by French neurosurgeons to isolate the spontaneous intracerebral haemorrhage as a clinical entity (David and Hecaen, 1945; Guillaume and Joinville, 1945) suitable for neurosurgical treatment, also the studies by Italian neurologists to forward operative treatment of intracerebral haemorrhagic lesions (Fazio, 1950). In reporting these eight cases we wish to contribute to the clinical knowledge, recognition, and timely treatment of the non-traumatic, spontaneous sub-cortical haematoma which, we feel, exists as a clinical entity, while proofs of a uniform aetiology and pathogenesis are still wanted.