A Unique Case of Stroke and Upper Limb Paralysis in a Mid-18th Century Natural Mummy.

Abstract

Despite its globally acknowledged importance in the clinical setting, the history of stroke has to date only been reconstructed through historical descriptions, whereas no clear palaeopathological evidence has ever been adduced. Here, a unique case of a naturally mummified body from the mid-18th century is shown to have a high degree of contracture of the upper left hand, whereas coeval documentary sources clearly indicate that the patient experienced a stroke in the last phase of his life that left him disabled. This example highlights how a combination of historical research and traditional palaeopathology can help in the reassessment of the presence of cerebrovascular diseases in the past. Stroke represents the second leading cause of death above age 60 globally and a leading cause of disability.1 By understanding its history and evolution, future preventive and therapeutic strategies may be improved. Cardiovascular diseases are complex entities caused by the interplay between genetics and environmental modulation, greatly increased in prevalence and incidence in Western societies on account of the drop in infectious disease–related mortality, longer life spans, and hypercaloric lifestyles.2 Historically, stroke was first described by Hippocrates (460–370 BC) who coined the term apoplexy and related an ischemic insult to a paralytic outcome, but a clear physiopathological understanding had to wait until the 17th-century discoveries of Johann Jacob Webpfer (1620–1695). In particular, the Swiss physician described the origins and terminations of the carotid and vertebral arteries at the arterial circle at the brain base. He also documented their occlusion and calcification and the fact that stroke could be provoked by a hemorrhage within the brain. This latter discovery proved to be a physiopathological turning point.3,4 Later in that century, the 1664 masterpiece Cerebri Anatome of Thomas Willis (1621–1675) further clarified cerebral vascular irroration, but it would be another …