Fig. 70.—Cirsoid Aneurysm of Orbit and Face, which developed after a blow on the Orbit with a cricket ball.
(From a photograph lent by Sir Montagu Cotterill.)
Arterial Angioma or Cirsoid Aneurysm.—This is composed of the enlarged branches of an arterial trunk. It originates in the smaller branches of an artery—usually the temporal—and may spread to the main trunk, and may even involve branches of other trunks with which the affected artery anastomoses.
The condition is probably congenital in origin, though its appearance is frequently preceded by an injury. It almost invariably occurs in the scalp, and is usually met with in adolescent young adults.
The affected vessels slowly increase in size, and become tortuous, with narrowings and dilatations here and there. Grooves and gutters are frequently found in the bone underlying the dilated vessels.
There is a constant loud bruit in the tumour, which greatly troubles the patient and may interfere with sleep. There is no tendency either to natural cure or to rupture, but severe and even fatal hæmorrhage may follow a wound of the dilated vessels.
The condition may be treated by excision or by electrolysis. In excision the hæmorrhage is controlled by an elastic tourniquet applied horizontally round the head, or by ligation of the feeding trunks. In large tumours the bleeding is formidable. In many cases electrolysis is to be preferred, and is performed in the same way as for nævus. The positive pole is placed in the centre of the tumour, while the negative is introduced into the main affluents one after another.
ANEURYSM
An aneurysm is a sac communicating with an artery, and containing fluid or coagulated blood.