Posttraumatic optochiasmatic arachnoiditis

Seven cases of adhesive arachnoiditis of the optochiasmatic cistern, verified surgically, with a history of head injury are presented. Neuroophthalmologic findings consisted of impairment of visual acuity and funduscopic atrophy rather than papilledema. The visual fields showed a damage of the periaxial rather than the axial type. Neuroradiologic examinations did not consistently give the findings considered classical of optochiasmatic arachnoiditis. Surgical lysis of the adhesions has given an improvement of the visual function, or at least an arrest in its impairment, in almost all cases. It is thought that these cases still present some valid indications for neurosurgical exploration of the optochiasmatic region.