Apoplexy

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Apoplexy (from Ancient Greek ἀποπληξία (apoplexia) 'a striking away') refers to the rupture of an internal organ and the associated symptoms. Informally or metaphorically, the term apoplexy is associated with being furious, especially as "apoplectic". Historically, it was used to describe what is now known as a hemorrhagic stroke, involving a ruptured blood vessel in the brain. However, modern health care professionals typically specify the anatomical location of the bleeding, such as cerebral, ovarian, or pituitary. [1] [2] [3]

Contents

Historical meaning

From the late 14th to the late 19th century, apoplexy referred to any sudden death that began with abrupt loss of consciousness, especially when the victim died within seconds after losing consciousness. The word apoplexy was sometimes used to refer to the symptom of sudden loss of consciousness immediately preceding death. Strokes, ruptured aortic aneurysms, and even heart attacks were referred to as apoplexy in the past, because before the advent of medical science, there was limited ability to differentiate abnormal conditions and diseased states. Although physiology as a medical field dates back at least to the time of Hippocrates, until the late 19th century physicians often had inadequate or inaccurate understandings of many of the human body's normal functions and abnormal presentations. Hence, identifying a specific cause of a symptom or of death often proved difficult or impossible. [4] [5] [6] [7] [8]

Hemorrhage

To specify the site of bleeding, the term "apoplexy" is often accompanied by a descriptive adjective. For instance, bleeding within the pituitary gland is termed "pituitary apoplexy," and bleeding within the adrenal glands is referred to as "adrenal apoplexy." [9]

Apoplexy also includes hemorrhaging with the gland and accompanying neurological problems such as confusion, headache, and impairment of consciousness. [10]

See also

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<span class="mw-page-title-main">Intracerebral hemorrhage</span> Type of intracranial bleeding that occurs within the brain tissue itself

Intracerebral hemorrhage (ICH), also known as hemorrhagic stroke, is a sudden bleeding into the tissues of the brain, into its ventricles, or into both. An ICH is a type of bleeding within the skull and one kind of stroke. Symptoms can vary dramatically depending on the severity, acuity, and location (anatomically) but can include headache, one-sided weakness, numbness, tingling, or paralysis, speech problems, vision or hearing problems, memory loss, attention problems, coordination problems, balance problems, dizziness or lightheadedness or vertigo, nausea/vomiting, seizures, decreased level of consciousness or total loss of consciousness, neck stiffness, and fever.

<span class="mw-page-title-main">Intraparenchymal hemorrhage</span> Medical condition

Intraparenchymal hemorrhage (IPH) is one form of intracerebral bleeding in which there is bleeding within brain parenchyma. The other form is intraventricular hemorrhage (IVH).

<span class="mw-page-title-main">Brain herniation</span> Potentially deadly side effect of very high pressure within the skull

Brain herniation is a potentially deadly side effect of very high pressure within the skull that occurs when a part of the brain is squeezed across structures within the skull. The brain can shift across such structures as the falx cerebri, the tentorium cerebelli, and even through the foramen magnum. Herniation can be caused by a number of factors that cause a mass effect and increase intracranial pressure (ICP): these include traumatic brain injury, intracranial hemorrhage, or brain tumor.

Pituitary apoplexy is bleeding into or impaired blood supply of the pituitary gland. This usually occurs in the presence of a tumor of the pituitary, although in 80% of cases this has not been diagnosed previously. The most common initial symptom is a sudden headache, often associated with a rapidly worsening visual field defect or double vision caused by compression of nerves surrounding the gland. This is often followed by acute symptoms caused by lack of secretion of essential hormones, predominantly adrenal insufficiency.

<span class="mw-page-title-main">Intraventricular hemorrhage</span> Medical condition

Intraventricular hemorrhage (IVH), also known as intraventricular bleeding, is a bleeding into the brain's ventricular system, where the cerebrospinal fluid is produced and circulates through towards the subarachnoid space. It can result from physical trauma or from hemorrhagic stroke.

Autoimmune hypophysitis is defined as inflammation of the pituitary gland due to autoimmunity.

Reversible cerebral vasoconstriction syndrome is a disease characterized by a weeks-long course of thunderclap headaches, sometimes focal neurologic signs, and occasionally seizures. Symptoms are thought to arise from transient abnormalities in the blood vessels of the brain. In some cases, it may be associated with childbirth, vasoactive or illicit drug use, or complications of pregnancy. If it occurs after delivery it may be referred to as postpartum cerebral angiopathy.

Adrenal hemorrhage (AH) is acute blood loss from a ruptured vessel of the adrenal glands above the kidneys.

References

  1. Melissa Conrad Stöppler, MD (February 7, 2011). "Definition of Apoplexy". OED Online. Oxford University Press.
  2. "apoplexy". Collins English Dictionary . HarperCollins. 2012. Retrieved May 9, 2022 via dictionary.reference.com.
  3. Coupland, AP; Thapar, A; Qureshi, MI; Jenkins, H; Davies, AH (2017). "The definition of stroke". J R Soc Med. 110 (1): 9–12. doi:10.1177/0141076816680121. PMC   5298424 . PMID   28084167.
  4. Engelhardt E (2017). "Apoplexy, cerebrovascular disease, and stroke: Historical evolution of terms and definitions". Dement Neuropsychol. 11 (4): 449–453. doi:10.1590/1980-57642016dn11-040016. PMID   29354227.
  5. Bauer M, Lang C, Patzelt D (2001). "Sudden death due to pituitary apoplexy". Leg Med (Tokyo). 3 (3): 183–186. doi:10.1016/s1344-6223(01)00026-8. PMID   12935525.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  6. Schutta HS, Howe HM (2006). "Seventeenth century concepts of "apoplexy" as reflected in Bonet's "Sepulchretum"". J Hist Neurosci. 15 (3): 250–268. doi:10.1080/09647040500403312.
  7. Lidell JA (1873). A Treatise on Apoplexy, Cerebral Hemorrhage, Cerebral Embolism, Cerebral Gout, Cerebral Rheumatism, and Epidemic Cerebro-spinal Meningitis. New York: W. Wood & Company.
  8. Kleisiaris CF, Sfakianakis C, Papathanasiou IV (2014). "Health care practices in ancient Greece: The Hippocratic ideal". J Med Ethics Hist Med. 7: 6. PMC   4263393 . PMID   25512827.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  9. Bashari, WA; Myint, YMM; Win, ML; Oyibo, SO (June 13, 2020). "Adrenal Insufficiency Secondary to Bilateral Adrenal Hemorrhage: A Case Report". Cureus. 12 (6): e8596. doi: 10.7759/cureus.8596 . PMC   7294864 . PMID   32550089.{{cite journal}}: CS1 maint: date and year (link)
  10. Mohr, G.; Hardy, J. (1982). "Hemorrhage, necrosis, and apoplexy in pituitary adenomas". Surg Neurol. 18 (3): 181–189. doi:10.1016/0090-3019(82)90388-3. PMID   7179072.