Skip to main content
. 2017 Oct-Dec;11(4):449–453. doi: 10.1590/1980-57642016dn11-040016

Box 2. "Apoplexy" in the Modern era (from 17th century on): discovery of subtypes timeline – authors and excerpts.

Johann Jakob Wepfer (1620-1695) (Swiss). Distinguished for the first time non-traumatic intracranial bleeding - in one case: "...cut the dura mater, much blood discharged from the space between it and the pia-mater [subarachnoid space] ..."; in another case: bleeding with ruptured anterior cerebral artery branch; in one more case, with serous liquid (pale-colored serum) accumulation (1658).23
The (non-traumatic, spontaneous) "hemorrhagic apoplexy" [intracranial hemorrhage], [subarachnoid hemorrhage], and [cerebral hemorrhage] due to vascular cause, and a non-hemorrhagic variety, emerged.
William Cole (1635-1716) (English). The first to use the term "stroke" to denote "apoplexy" in English medical writing (1689).24
Franciscus (Francesco) Biumi (xxxx-xxxx) (Italian). Described a case of "apoplexy", without intracranial bleeding, identifying: "...internal carotid aneurysmal sack [saccular aneurysm] in the cavernous sinus (Vieussens receptacle)..." [aneurysm - unruptured] (1765).25
Giovanni Battista Morgagni (1682-1771) (Italian). Distinguished a "sanguineous" (with bleeding) [hemorrhagic], a "serous" (with intracranial fluid) [non-hemorrhagic], and a "neither sanguineous nor serous" type apoplexy (1761).26
John Blackall (1771-1860) (English). Described: "...haemorrhage in the space between the meninges... [subarachnoid hemorrhage] ...traced to the basilar artery...at its bifurcation was dilated into an aneurysmal sac [basilar artery aneurysm] ... opened into the cavities" [aneurysm - ruptured] (1814).27
Jean André Rochoux (1787-1852) (French). Defined "hemorrhagic apoplexy" [cerebral hemorrhage], and introduced the term ramollissement du cerveau [softening of the brain ] [infarction] (1814).28
Léon Louis Rostan (1796-1866) (French). Defined "sanguine (hemorrhagic) apoplexy" [cerebral hemorrhage] and extended the notion of (noninflammatory) "cerebral softening" (ramollissement cérébral) [cerebral infarction] (1819); he considered "apoplexy" only for hemorrhagic events.29
Améedée Dechambre (1812-1886) (French). Introduced the term lacune [lacune] for small rounded cavities probably resulting from the liquefaction after partial resorption within foci of softening (1838).30
Charles Louis Maxime Durand-Fardel (1815-1899) (French). Described "hemorrhage" (meningeal, cerebral) [subarachnoid hemorrhage] [cerebral hemorrhage], "brain softening" [cerebral infarction], "interstitial atrophy of the brain" [white matter rarefaction (demyelination and axonal loss)], "lacune", and état criblé du cerveau (riddled state of the brain).31
Rudolf Ludwig Karl Virchow (1821-1902) (German). Introduced the terms apoplexia sanguinea (Hämorrhagische Apoplexie des Gehirns) (hemorrhagic apoplexy of the brain) [cerebral hemorrhage], and apoplexia ischaemica (ischaemic apoplexy) (Hirnerweichung) [cerebral softening] [cerebral infarct], caused by embolism; created the terms "thrombosis" and "embolism"; revived the term "arteriosclerosis" (according to Lobstein, 1829) (1852).32
Jean-Baptiste Vincent Laborde (1830-1903) (French). Described the "pisiform lacunes" (lacunes pisiformes) as "...small cystic cavities...small blood effusions that have suffered a complete resorption...in other cases ...their centers ...resulting from partial and progressive disorganization..." for "lacunes" [post-hemorrhage and post-softening] (1866).33
Julius Friedrich Cohnheim (1839-1884) (German). Introduced the terms Infarct [infarct, infarction], Nekrose [necrosis] and hämorraghischer Infarct [hemorrhagic infarct], after embolic obstruction of terminal arteries (1872).34
Otto Ludwig Binswanger (1852-1929) (Swiss). Described marked atrophy of the subcortical white matter he named "Chronic progressive subcortical encephalitis" (1894), later named after him, and subsequently known as "Binswanger disease".35 , 36
Alois (Aloysius) Alzheimer (1864-1915) (German). Described diffuse and focal subtypes of vascular injuries of the brain, including focal cortical atrophic changes (senile Sklerose der Hirnrinde and senile Rindenverödung), "cortical microinfarcts" (1899-1902).37 , 38