Journal List > J Korean Neurotraumatol Soc > v.5(1) > 1084046

Kim, Shin, Park, Lee, and Chung: Penetrating Injury of Optic Chiasm after Head Injury

Abstract

We report a case of penetrating injury of optic chiasm caused by severe head injury. Direct injury to the anatomically privileged optic chiasm is relatively rare complication. A 67-year-old male suffered a blunt head injury due to a fall accident. He complained total blindness of both eyes. Computed tomography (CT) revealed fracture of planum sphenoidale and the bone fragment which seems to compress the optic chiasm. The patient was taken to the operating room emergently for a intracranial decompression of the optic chiasm. Postoperatively, we performed a high-dose steroid therapy. The patient required prolonged hospitalization followed by transfer to a rehabilitation facility. Two months after the accident, the patient underwent a neuroophthalmologic evaluation. At that time, he was still blind in both eyes. On visual evoked potential (VEP), no evoked potential was noted.

Figures and Tables

FIGURE 1
A 67-year old male. His initial skull X-ray (A, B) showed multiple craniofacial fractures.
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FIGURE 2
Computed tomography revealed fracture of planum sphenoidale (A) and the bone fragment (arrow) which seems to compress the optic chiasm (B).
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FIGURE 3
Intraoperatively, the right optic nerve (ON), which was separated from the optic chiasm and displaced downwardly, and the bone fragment (*) were identified.
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FIGURE 4
Postoperatively, the bone fragment was totally removed.
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