Death shortly ensued, and at the
necropsy a fracture through the roof of the orbit was revealed,
the umbrella point having completely severed the optic nerve and
divided the ophthalmic artery. The internal carotid artery was
wounded in one-half of its circumference at its bend, just before
it passes up between the anterior clinoid process and the optic
nerve. The cavernous sinus was also opened. In this rare injury,
although there was a considerable quantity of clotted blood at
the base of the brain, there was no wound to the eyeball nor to
the brain itself.
Pepper records a case in which a knife was thrust through the
spheroidal fissure, wounding a large meningeal vein, causing
death from intracranial hemorrhage. Nelaton describes an instance
in which the point of an umbrella wounded the cavernous sinus and
internal carotid artery of the opposite side, causing the
formation of an arteriovenous aneurysm which ultimately burst,
and death ensued. Polaillon saw a boy of eighteen who was found
in a state of coma. It was stated that an umbrella stick had been
thrust up through the roof of the orbit and had been withdrawn
with much difficulty. The anterior lobe of the brain was
evidently much wounded; an incision was made in the forehead and
a portion of the frontal bone chiseled away entrance being thus
effected, the aura was incised, and some blood and cerebrospinal
fluid escaped.
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