. Surgery, its principles and practice . JFiG. 495.—Pulsating Exophthalmos (frora a caseunder the care of Dr. Kent Wheelock, FortWayne, Indiana). PULSATING EXOPHTHALMOS, 927 six to gunshot wounds, and seven to punctured or penetrating right eye was affected in thirty-one and the left in twenty-six ofthe cases. Five of the cases were bilateral. Rupture of the internalcarotid in the cavernous sinus may result not only from a direct trauma,. Fig. 496.—Case of Bilateral Exophthalmos. as, for example, a penetrating wound or gunshot injury, but from an in-direct trauma, as, for example, a
. Surgery, its principles and practice . JFiG. 495.—Pulsating Exophthalmos (frora a caseunder the care of Dr. Kent Wheelock, FortWayne, Indiana). PULSATING EXOPHTHALMOS, 927 six to gunshot wounds, and seven to punctured or penetrating right eye was affected in thirty-one and the left in twenty-six ofthe cases. Five of the cases were bilateral. Rupture of the internalcarotid in the cavernous sinus may result not only from a direct trauma,. Fig. 496.—Case of Bilateral Exophthalmos. as, for example, a penetrating wound or gunshot injury, but from an in-direct trauma, as, for example, a blow on the head, although it is possiblethat in some of the cases in which a basal fracture has taken place and thesymptoms of pulsating exophthalmos have developed, a penetrating splin-ter of bone has caused the aneurismal varix. Where the traumatism hasbeen an indirect one, it is likely that adiseased condition of the vascular systemhas been a predisposing factor. Among three hundred and thirteencases thus far analyzed, the number aris-ing spontaneously or resulting from thegrowth of a tumor is eighty-three, andof these fully 80 per cent, were of spon-taneous origin. The spontaneous casesmost frequently occur among females,and usually develop as the result ofstraining efforts, coughing, or vomiting,and in persons who are predisposed tosuch an accident by reason of vasculardisease. The subject of this affectionusually has a sensation of
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