ABBREVIATIONS MRA Magnetic resonance angiography RCVS Reversible cerebral vasoconstriction syndromeReversible cerebral vasoconstriction syndrome (RCVS) is a clinicoradiological diagnosis comprising 'thunderclap' headaches and reversible segmental vasoconstriction of cerebral arteries, occasionally complicated by ischaemic or haemorrhagic stroke. We report a case of RCVS in a 13-yearold male with severe thunderclap headaches and no focal neurological signs. Brain imaging showed multiple posterior circulation infarcts; cerebral computed tomography, magnetic resonance imaging, and catheter angiography showed multifocal irregularity and narrowing, but in different arterial segments. Laboratory studies did not support a diagnosis of vasculitis. Symptoms resolved over 3 weeks; magnetic resonance angiography 3 months later was normal and remained so after 2 years. We highlight the typical clinical features of RCVS in this case and suggest that the diagnosis should be considered in children with thunderclap headaches or stroke syndromes where headache is a prominent feature, especially if cerebrovascular imaging studies appear to be evolving or discrepant.Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by acute 'thunderclap' (sudden and severe) headache with imaging evidence of segmental cerebral arterial vasoconstriction and dilatation that completely resolves over a period of months. Most cases resolve spontaneously, but arterial ischaemic stroke and intracerebral and subarachnoid haemorrhages complicate a minority. Here we report a paediatric case of RCVS to highlight this as a potential differential diagnosis for both acute childhood headache and stroke. Parental written consent was given for the anonymized publication of this case. CASE REPORTA 13-year-old male developed a sudden severe headache, without other neurological deficits, after swimming in cold seawater. Migraine was diagnosed and he was given sumatriptan. Three days later he presented with an unprovoked severe diffuse headache, only partially controlled with intravenous opiates. Cardiovascular, neurological, and systemic examination was normal. He had a history of uncomplicated migraine, with infrequent mild headache. He was on no medication and denied alcohol, tobacco, or substance misuse. Family history was negative for headache, migraine, or premature vascular disease. Unenhanced head computed tomography (CT) at initial presentation was normal. Cerebrospinal fluid examination showed normal opening pressure, normal protein and glucose, and no cells or xanthochromia. Brain magnetic resonance imaging (MRI) on day 12 showed multiple acute infarcts in the occipital and parietal cortices, left cerebellar hemisphere, and posterior deep white matter (Fig. 1), all within the territory of the posterior circulation. Time-of-flight magnetic resonance angiography (MRA) of the cervical and intracranial arteries showed a diffusely small right vertebral artery, with marked attenuation of flow in its V3 segment; there was also turbulent flow in ...
The inspiration for this special issue came from our observation that the British and American approaches to family policy in general, and to marriage and cohabitation in particular, set them apart from their closest neighbors in Europe and North America, respectively. While certain demographic trends can be observed across the Western world, the response of Britain and the United States to such trends differs significantly from that of other jurisdictions in terms of family policy.
This article reviews the complex, and sometimes conflicting, policies adopted by the law of England and Wales over the course of the twentieth century. Its aim is to highlight the fact that cohabitation is not merely a modern legal issue, but one with which both the legislature and the courts have had to grapple for decades. It argues that reform has been piecemeal and context-specific because the courts and legislature have not adopted a coherent policy toward cohabiting relationships.
In recent years the courts have been faced with the problem of deciding what status should be given to marriages that are celebrated outside the provisions of the Marriage Act 1949 yet believed to be valid by the parties to them. Some such marriages have been classified as non‐marriages, while others have been saved by the application of the presumption in favour of marriage. The decisions are unsatisfactory for a number of reasons. It will be suggested that the concept of non‐marriage should be confined to ceremonies that in no way purport to be marriages. The presumption in favour of marriage should also be limited to situations where there is a valid basis for presuming a marriage rather than being used to avoid dealing with the deficiencies of the law.
This article examines the extent of compliance with the Clandestine Marriages Act 1753 through three parish studies. It demonstrates that the vast majority of the sample cohort of parents whose children were baptized in church, and indeed of couples living together, had married in church as required by the 1753 Act, and shows how the proportion of marriages traced rises as more information about the parties becomes available. Through a study of settlement examinations, the article posits an explanation of why some marriages have not been traced, and argues that researchers should be cautious in inferring non-compliance from the absence of a record in a specific parish. It is also argued that the reason for such high rates of compliance has less to do with the power of statute and more to do with the fact that the 1753 Act was not such a radical break with the past as has been assumed.
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This book uses a wide range of primary sources - legal, literary and demographic - to provide a radical reassessment of eighteenth-century marriage. It disproves the widespread assumption that couples married simply by exchanging consent, demonstrating that such exchanges were regarded merely as contracts to marry and that marriage in church was almost universal outside London. It shows how the Clandestine Marriages Act of 1753 was primarily intended to prevent clergymen operating out of London's Fleet prison from conducting marriages, and that it was successful in so doing. It also refutes the idea that the 1753 Act was harsh or strictly interpreted, illustrating the courts' pragmatic approach. Finally, it establishes that only a few non-Anglicans married according to their own rites before the Act; while afterwards most - save the exempted Quakers and Jews - similarly married in church. In short, eighteenth-century couples complied with whatever the law required for a valid marriage.
Between 1795 and 1853, over 250 men and women were sentenced to transportation for committing the crime of bigamy. This harsh treatment is at odds with the assumption that the sentences handed down to bigamists were generally light. This article provides the first in-depth study of the use of transportation in this context, drawing on the criminal registers, the Proceedings of the Old Bailey, and local and national newspaper reports in order to ascertain who was transported for bigamy, and why. Analysing a range of aggravating and mitigating factors, it shows why certain cases were deemed to merit the harshest form of punishment, while others, despite exhibiting some of the same factors, were treated more leniently. The sheer greed, deceit and nastiness demonstrated by many of these bigamists provides a significant counter-narrative to the depiction of bigamy as a substitute for divorce and raises broader questions about its incidence.
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