Ligation of the common carotid artery for malignant recurrent hemorrhage of the vitreous / George S. Derby.

  • Derby, George S.
Date:
1907
Catalogue details

Licence: In copyright

Credit: Ligation of the common carotid artery for malignant recurrent hemorrhage of the vitreous / George S. Derby. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    G from the Zurich clinic, gives 4 per cent, in 31 < ^ maim- 7'' 95 cases> some of the patients of S ^operated on m the pre-aatiseptic gives a £ot tality oi 10 per cent. Werner7 10 per cent Lo FnrP 12 per cent., Murray. 10 per cent./de SKiM per cent. For other diseases the mortality is much greater as would be expected when we take into account the serious chapter of the lesions which call for this operation. Keller' gives 34-43 per cent., Le Fort* 43 per cent., Murray0 25 per cent. The total results of carotid liga- tion as quoted by Barnard and Rugby11 are as follows: Human 31 per cent., Zimmermann 31 per cent. Piiz lb per cent., and Friedlander 13 per cent. As regards the dangers and complications of the op- eration, Erichsen, quoted by Barnard and Rugby,11 savs that cerebral symptoms occur early or late in 25 per cent oi the cases. The dangers of sepsis and hemorrhage may now be disregarded. Blindness, from obstruction of the arteria centralis retina?, has been noted by Elschnig,12 Siegristia Gif- ford and Uhthoff,15 and lias apparently in the majority of instances been caused by lodgment in this vessel of a fragment detached from the thrombus in the carotid. In any event this is an uncommon accident, for in the ordinary case closure of the carotid causes but a tem- porary disturbance of the retinal circulation. Uhthoff13 and Hansell10 have observed the temporary obliteration of the retinal vessels at the moment of ligation. Sattler,17 Wagenmaun18 and Silex10 have seen lesions of the cornea, which have been referred both to trauma and to trophic disturbance. Axenfeld20 has reported homonymous hemianopsia following ligation, and C. Doctordiss. Copenhagen, see Michel's Jahresbericht, 1898, 61 2 7. Inaug. Dis.s. TUbingen, see Michel's Jahresbericlit 1898 (ilT 8. Rev. de Chir., 1890, May and June. 9. Ann. of Surg., 1904, 421. 10. Quoted in Modern Ophthalmology; Ball, C40. 11. Ann. or Surg.. 1904, 649. 12. Arch. f. Ophth., 1S93, xxxix. 151. 13. Ber. d. Ophth. .Gesell. z. Heidelberg, 1S9S, 10. 14. Ophth. Kec, 1899, 595. 15. Ber. d. Ophth. Gesell, 1898. 21. 22. 10. The Journal a. m. A., 1905, 53G. 17. Quoted by Slegrist (13). is. Quoted by Slegrist (13). 19. Her. (1. Ophth. Gesell., 1898, 2:;. •jo. Ber, d. Ophth, Gesell., 1898, 22.