Some defect in vision commonly persists, dependent on muscular paresis (on account of the previous stretching), retinal thrombosis, or corneal changes. The longer radical treatment was deferred the greater and more distressing were the after-effects of the lesion.
According to Sattler, however, the results obtained by ligature of the common carotid are less favourable than as stated above, and by no means devoid of danger to life. Fifty-six cases were collected with results as below:—
39 cases recovered and showed marked improvement.
11 cases experienced no benefit.
8 cases died.
It has been urged that ligature of the internal carotid artery would suffice to bring about equally satisfactory results, combined with less danger to life and diminished risk of secondary cerebral degeneration. Such, however, does not seem to be the case, for the anastomosis between the angular arteries and between the terminal branches of the ophthalmic is so free that the results obtained by ligature of the internal carotid appear to be unsatisfactory. Indeed, even when the larger trunk was tied, secondary operations have been occasionally required in order to excise some large anastomotic channel in the region of the inner canthus of the eye and over the bridge of the nose.
From these data, the following conclusions can be drawn:—
1. That by means of rest, careful dieting, and administration of potassium iodide in large doses, the progress of the case can sometimes be arrested, but that much patience is required and the ultimate result is entirely problematical.
2. That compression—digital or instrumental, intermittent or continuous—is painful, tedious, and usually quite inefficacious.
3. That ligature of the common carotid affords the best chance of cure or alleviation.