In 29 cases the exact duration of the illness was not known, but was thought to be less than one day. Thus, of the total (248), 178 (72%) were seen within 24 hours. No patient received active treatment other than nursing attention and general medical supervision; in a few of them therapeutic lumbar puncture was carried out. One hundred and forty four (58%) died, and whenever it was possible post-mortem examination was carried out: in only 50 per cent was permission granted. In no case seen by the author did a cerebral vascular accident cause sudden death. In the majority, death occurred after a period of days; the interval was never less than 6 hours. enable the investigator to assess the results of specificforms of treatment. Accordingly, a survey was carried out on a number of'untreated'cases seen shortly after the onset of a cerebral vascular accident, with particular reference to the presence of signs which had prognostic value.

This review refers to 252 patients over the age of 40 (120 males and 132 females) in whom a cerebral vascular accident had occurred within the previous 7 days. These were completely unselected cases. Four males were excluded, however, either on account of uncertainty of diagnosis or because of lack of sufficient information. The duration of the lesion when the patients were first seen is given in Table 1.