Abstract Damage to the optic chiasm is an unusual sequela to head injury. Especially interesting and rare is the lesion which simulates a sagittal section of the chiasm. The precise pathophysiology of this occurrence is still subject to discussion. Report of Case In April, 1959, the patient, a 20-year-old white man, was injured in an automobile accident, striking his head and losing consciousness for an undetermined period of time. Examination by a neurosurgeon following the injury revealed no neurological abnormalities other than slight confusion and disorientation. There was a small laceration in the right frontal area and marked bilateral periorbital edema and ecchymosis.Fluid was thought to be behind the eardrums, giving rise to a suspicion that a basilar skull fracture might be present.A lumbar puncture revealed a cerebrospinal fluid pressure of 240 mm. of water. There were 290,000 red blood cells per cubic millimeter and an elevated total protein. References 1. Traquair, H. M.; Dott, N., and Russell, W. R.: Traumatic Lesions of the Optic Chiasma , Brain 58:398-411 ( (Sept.) ) 1935.Crossref 2. Duke-Elder, W. S.: Textbook of Ophthalmology , Vol. 4, St. Louis, The C. V. Mosby Company, 1949, pp. 3559-3566. 3. Osterberg, G.: Traumatic Bitemporal Hemianopia (Sagittal Tearing of the Optic Chiasma) , Acta ophth. 16:466-474, 1938.Crossref 4. Evans, J. N., and Browder, J.: Problem of Split Macula; Study of Visual Fields , A.M.A. Arch. Ophth. 31:43-53 ( (Jan.) ) 1944.Crossref 5. Louw, J. G.: Traumatic Bisection of Optic Chiasma; Case Report , South African M.J. 28:971-975 ( (Nov.) ) 1954. 6. François, J.; Neetens, A., and Collette, J. M.: Vascularization of the Primary Optic Pathways , Brit. J. Ophth. 42:65-80 ( (Feb.) ) 1958.Crossref 7. Hughes, B.: Blood Supply of the Optic Nerves and Chiasm and Its Clinical Significance , Brit. J. Ophth. 42:106-125 ( (Feb.) ) 1958.Crossref
A.M.A. Archives of Ophthalmology – American Medical Association
Published: Apr 1, 1960
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