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Traumatic bitemporal hemianopia.

Elizabeth Marriott1, Walter M Jay

  • 1Loyola University Medical Center, Maywood, IL 60153, USA.

Seminars in Ophthalmology
|March 17, 2007
PubMed
Summary
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High-speed vehicle accidents can cause severe head trauma, leading to optic chiasm damage. This injury may result in bitemporal hemianopia, a rare but significant visual field defect.

Area of Science:

  • Neuroscience
  • Ophthalmology
  • Trauma Surgery

Background:

  • A 45-year-old male pedestrian sustained severe head trauma from a high-speed motor vehicle accident.
  • Initial assessment revealed a Glasgow Coma Scale score of 3T, indicating a critical brain injury.

Observation:

  • The patient presented with multiple facial and sinus fractures, a right orbital wall fracture, and a depressed open frontal skull fracture with exposed brain parenchyma.
  • An emergent right frontal craniectomy was performed due to the severity of the brain injury.
  • Following prolonged hospitalization and rehabilitation, a neuro-ophthalmologic evaluation was conducted six weeks post-accident.

Findings:

  • Visual acuity was significantly reduced to 20/200 in both eyes.
  • Visual field testing revealed a bitemporal hemianopia.

Related Experiment Videos

  • Ophthalmoscopic examination showed bilateral temporal disc pallor, more pronounced on the right.
  • Neuroimaging confirmed optic chiasm damage.

    • Implications:

    • Head trauma can cause rare but severe visual field defects like bitemporal hemianopia due to optic chiasmal injury.
    • This case highlights the importance of comprehensive neuro-ophthalmologic evaluation in patients with severe head trauma.
    • Understanding the link between traumatic brain injury and visual pathway damage is crucial for patient management and prognosis.