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Traumatic homonymous hemianopia.

B B Bruce1, X Zhang, S Kedar

  • 1Department of Neurology, Massachusetts General Hospital, Harvard University, School of Medicine, Boston, Massachusetts, USA.

Journal of Neurology, Neurosurgery, and Psychiatry
|April 1, 2006
PubMed
Summary
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Traumatic brain injury (TBI) commonly causes homonymous hemianopia, often from motor vehicle accidents. A significant delay in diagnosis impacts rehabilitation for these young patients.

Area of Science:

  • Neuroscience
  • Ophthalmology
  • Traumatology

Background:

  • Homonymous hemianopia is a visual field defect resulting from damage to the postchiasmal visual pathways.
  • Traumatic brain injury (TBI) is a significant cause of acquired brain damage, potentially leading to various neurological deficits, including visual impairments.

Purpose of the Study:

  • To characterize patients experiencing homonymous hemianopia secondary to traumatic brain injury (TBI).
  • To analyze the demographic, clinical, and neuroimaging features of TBI-related homonymous hemianopia.

Main Methods:

  • Retrospective review of patients with homonymous hemianopia and a history of TBI.
  • Inclusion criteria: detailed clinical information and neuroimaging results.
  • Data collected: demographics, clinical presentation, visual field defect type, lesion location, and evolution.

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Main Results:

  • 103 TBI patients (112 cases) with homonymous hemianopia were identified.
  • Motor vehicle accidents were the most common cause (57.1%), followed by violence (17%) and falls (15.2%).
  • Incomplete homonymous hemianopia was more frequent (60.7%) than complete (39.3%); lesions were often multiple (53.6%).

Conclusions:

  • TBI-related homonymous hemianopia predominantly affects younger males, often resulting from motor vehicle accidents.
  • Patients frequently present with multiple brain lesions and a median diagnostic delay of 5 months post-injury.
  • Delayed diagnosis may impede effective rehabilitation and driving training for affected individuals.