BILATERAL LUMBAR SYMPATHETIC NEURECTOMY IN THE TREATMENT OF MALIGNANT HYPERTENSION

Abstract

Malignant hypertension affects persons in the prime of life, by preference men with a drive, who have attained success at the expense of their vascular systems. In some instances, such hypertension develops from a benign form, while in others it is malignant in type, almost from its inception; the latter type has constituted approximately 10 per cent. of the total number of cases in our hospital experience. The cause of the disease is unknown; the course is stormy and rapid; the prognosis is extremely grave, and the medical treatment is entirely unsatisfactory. The clinical symptoms are: (1) marked and continuous elevation of systolic blood pressure and disproportionately high diastolic pressure; (2) cerebral manifestations—that is, excruciating dull headaches, intermittent or continuous in character, affecting as a rule the entire cranium, but centering especially in the occiput—insomnia, irritability and mental deterioration, changes in personality and at times apoplectic or epileptiform seizures; (3)