Post-traumatic chiasmatic disruption.
Ten patients with traumatic disruption of the optic chiasm are presented. The clinical sequence of fronto-facial trauma and CSF rhinorrhoea, followed days later by diabetes insipidus and discovery of a bi-temporal visual field loss constitute a characteristic syndrome which should be recognized by the attending medical staff. Magnetic resonance imaging, not previously reported, and post-mortem evidence point to a physical disruption of the chiasm and infundibulum as the cause of the visual and hypothalamic signs. The resulting field defect is permanent but the diabetes insipidus is transient in 50% of patients and can be adequately managed with manipulation of the patient's fluid intake.
Department of Neurosurgery, Groote Schuur Hospital, University of Cape Town, South Africa.
Z
Z
Domingo
J C
JC
de Villiers
D000293:Adolescent; D000328:Adult; D002559:Cerebrospinal Fluid Rhinorrhea / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D016489:Head Injuries, Closed / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009897:Optic Chiasm / Q000000981:diagnostic imaging / Q000293:injuries* / Q000473:pathology; D014057:Tomography, X-Ray Computed; D014794:Visual Fields / Q000502:physiology