pulsatile proptosis
Introduction
Introduction to pulsatile eyeball Pulsating exophthalmos (pulsatingexophthalmos) is common in the internal carotid artery and cavernous sinus vasospasm. Because the internal carotid artery passes through the cavernous sinus, it is a common site of arteriovenous fistula. The causes of pulsatile ocular protrusion can be divided into two categories: one is damaging, found in skull base fracture or penetrating injury. Second, idiopathic, less common, occurs in patients with congenital or acquired internal carotid aneurysm or arteriosclerosis, mostly unilateral. basic knowledge Sickness ratio: 0.0001% Susceptible people: no specific population Mode of infection: non-infectious Complications: exposed keratitis
Cause
Cause of pulsatile eyeball
The causes of this disease can be divided into two categories:
1. Injury: seen in a skull base fracture or a penetrating injury.
2. Idiopathic: Less common, occurring in patients with congenital or acquired internal carotid aneurysm or arteriosclerosis, mostly unilateral.
Prevention
Pulsatile eyeball prevention
In order to prevent seizures, do not press the jugular vein, the collar should not be too tight, do not bow to the heavy physical labor, the supine position should be taken.
Complication
Pulsating eyeball complication Complications exposed keratitis
Paralytic keratitis will occur, and when the eyeball is severely exposed, exposed keratitis is prone to occur.
Symptom
Symptoms of pulsatile eyeballs Common symptoms Recurrent papilledema keratitis palsy retinal hemorrhage varicose conjunctival hyperemia
1. The eyeball of the affected side is prominent, pulsating with the pulse and accompanied by noise.
2, with the finger pressing the eyeball or the ipsilateral common carotid artery can reduce the eye.
3, eyelids and conjunctiva swelling and congestion, there is double vision.
4, may have paralytic keratitis.
5, due to varicose veins, a soft mass can be reached above and inside the ankle.
6, fundus examination often found papilledema, retinal vein tortuosity and retinal hemorrhage, varying degrees of visual acuity.
7, the disease suddenly occurred, the affected side of the head and the back of the eye pain, the patient often complained that you can hear continuous rumble, the examiner can put the stethoscope on the eye and the ankle can also hear the same sound.
Examine
Examination of pulsatile eyeballs
In the case of exophthalmos with traumatic history, pulsation and murmur, the diagnosis is easy. When there is diplopia caused by III, VI, V cranial nerve palsy, the possibility of internal carotid artery and cavernous sinus vasospasm is very high. Helping to diagnose and determine the lesion site, the piercing of the dome, the exudation of the brain tissue into the sputum is easy to be confused with the disease, head X-ray film or CT examination, can provide a reliable basis for identification, in addition It should be noted that the tumors with abundant blood vessels in the sputum are differentiated, and the onset of vascular tumors is generally slow.
Diagnosis
Diagnosis and differentiation of pulsatile eyeballs
In the dome, the exudation caused by brain tissue detachment into the iliac crest is easily confused with the disease. The X-ray film or CT examination of the head can provide a reliable basis for identification. In addition, it should be noted that the sputum is rich in blood vessels. The identification of tumors, the general onset of vascular tumors is slow.
