Abstract
William Hunter in 1757, is credited with recognizing an arteriovenous aneurysm as direct communication between the artery and vein, while previous observers having interpreted the lesion as a simple aneurysm (Hunter 1762). He studied two patients in whose arms the vessels had been injured by phlebotomy, an operation extensively practiced at that time not only by physicians but also charlatans and barbers. His first accurate appraisal of an arteriovenous communication, described not only the bruit and the palpable thrill at the site of communication but also the marked dilatation and tortuosity of the artery at the site of the fistula: “In a former paper upon aneurysm, I took notice of a species of that complaint, which, so far as I know, had not been mentioned by any other author; where there is an anstomosis or immediate connection between the artery and the vein at the part where the patient let blood in consequence of the artery being wounded through the vein; so that blood passes immediately from the trunk of the artery into the trunk of the vein and so back into the heart. It will differ in its symptoms from the spurious aneurysm principally thus. The vein will be dilated or become vari- cose and it will have a pulsatile jarring motion on account of the stream from the artery. It will make a hissing noise, which will be found to correspond with the pulse for the same reason. The blood of the tumor will be altogether or almost entirely fluid because of its constant motion”.
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Benndorf, G. (2010). Historical Considerations. In: Dural Cavernous Sinus Fistulas. Medical Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-68889-1_2
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