A New Surgical Method for Treatment of Pulsating Exophthalmus

Abstract

Intracranial injuries to the internal carotid in the region of its passage through the cavernous sinus are becoming more and more important by the increase in traffic accidents. Spontaneous healing occurs, as one knows, only in a low percentage of the cases and is mostly a consequence of thrombosis. Surgical therapy does not possess an absolutely reliable method. There are limitations to the possibility of ligation of vessels because disturbances of brain circulation may easily be caused. On the other hand a ligature often remains ineffective if the collateral circulation is strongly developed. A cardiac arrest was additionally provided after incision of the sinus. The operation had a good effect and there was no evidence of a neurological deficit, although the patient died on the third postoperative day from a cardio-pulmonary complication. A case of pulsating exophthalmus is described in which after failure of the typical surgical methods the fistula in the cavernous sinus was directly approached. Thrombosis was induced by compression of the cavernous sinus with a tantalum plate.