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NEUROLOGY 1993;43:2400
© 1993 American Academy of Neurology

Mozart's chronic subdural hernatorna

Miles E. Drake, Jr., MD

Departments of Neurology and Psychiatry, Ohio State University College of Medicine, Clinical Neurophysiology Laboratory, Ohio Stair University Hospitals, Ohio State University Comprehensive Epilepsy Program, Columbus, OH

No commemoration of the bicentennial of Mozart's death would be complete without some consideration of that premature yet predictable demise. Mozart's premonitions of death are well known and apparently played a role in the composition of the K.626 Requiem and perhaps other works. His death has traditionally been ascribed to infectious causes, chiefly rheumatic fever or post-streptococcal glomerulonephritis, exacerbated by intemperance and chronic penury. Pathography has been difficult because of his supposed burial in a pauper's grave, the location and contents of which were later supposedly lost. Mozart's burial place in St. Mark's Cemetery in Vienna was known and, in the parlance of the day, "reorganized" a decade later, as the occupants of plots were disinterred to make room for the more recently deceased. A skull believed to be Mozart's was saved by the successor of the gravedigger who had supervised Mozart's burial, and then passed into the collections of the anatomist Josef Hyrtl, the municipality of Salzburg, and the Mozarteum museum (Salzburg). Forensic reconstruction of soft tissues related to this skull reveals substantial concordance with Mozart's portraits. The skull suggests premature closure of the metopic suture, which has been suggested on the basis of his physiognomy. A left temporal fracture and concomitant erosions raise the question of chronic subdural hematoma, which would be consistent with several falls in 1789 and 1790 and could have caused the weakness, headaches, and fainting he experienced in 1790 and 1791. Aggressive bloodletting to treat suspected rheumatic fever could have decompensated such a lesion to produce his death on December 5, 1791.

Address correspondence and reprint requests to Dr Miles E. Drake, Jr. 407 Means Hall, 1654 Upham Drive, Columbus, OH 43210

Presented in part at the 44th annual meeting of the American Academy of Neurology, San Diego, CA, May 1992

Received January 12, 1993 Accepted for publication in final form April 14, 1993







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