Traumatic bitemporal hemianopia.

Abstract

A 45-year-old male pedestrian was struck by a motor vehicle moving at high speed. Upon initial assessment, the patient scored a 3T on the Glasgow Coma Scale. The patient suffered multiple facial and sinus fractures, a right orbital wall fracture, and a depressed open frontal skull fracture with visible brain parenchyma. Due to the nature of the brain injury, the patient was taken to the operating room emergently for a right frontal craniectomy. The patient required prolonged hospitalization followed by transfer to a rehabilitation facility. Six weeks after the accident, the patient underwent an extensive neuro-ophthalmologic evaluation. At that time, visual acuity was 20/200 in both eyes. On visual field testing, a bitemporal hemianopia was noted. Ophthalmoscopic examination revealed bilateral temporal disc pallor, right greater than left. Neuroimaging demonstrated damage to the optic chiasm. Although rare, head trauma may cause a bitemporal hemianopia secondary to optic chiasmal injury.

• Authors: Elizabeth Marriott, Walter M Jay
• Journal: Seminars in ophthalmology (Semin Ophthalmol) 2007 Jan-Mar Vol. 22 Issue 1 Pg. 3-7 ISSN: 0882-0538 [Print] England
• PMID: 17366110 (Publication Type: Case Reports, Journal Article)

Topics

• Accidents, Traffic
• Electroencephalography
• Fractures, Open (complications, diagnosis, physiopathology)
• Frontal Bone (injuries)
• Hemianopsia (diagnosis, etiology, physiopathology)
• Humans
• Magnetic Resonance Imaging
• Male
• Middle Aged
• Multiple Trauma
• Orbital Fractures (complications, diagnosis, physiopathology)
• Trauma Severity Indices
• Visual Acuity
• Visual Field Tests
• Visual Fields