On The Spontaneous Cure Of A Case Of Pulsating Exophthalmos

Abstract

A case of traumatic pulsating exophthalmos is reported in a 22-year-old man who recovered spontaneously after eight years. The recovery was proceeded by orbital manifestations found two years before the disappearance of exophthalmos and intracranial murmur. Since systolic retinal artery pressure was higher at the damaged than at the sound side and since the ligation of the homolateral common carotid artery did not produce improvement, the author is of the opinion that crossed pulsating exophthalmos was present, though arteriographic examinations were not performed. In 1949, I published a report of a case of pulsating exophthalmos that recovered spontaneously in a way not unlike this case. The former case regarded a 24-year-old woman with pulsating exophthalmos that appeared after a bad bicycle fall. Eight years later the woman suddenly lost consciousness and, after regaining it, noticed she could no longer feel the endocranial pulsation. Later the exophthalmos disappeared gradually and all evidence of collateral venous stasis regressed. The recovery was attributed to the sudden closing of the fistula by a mobile thrombus and it was hypothesized that this was due to a valvular arteriovenous connection. (Noetic Sciences translation)