Neuro-ophthalmic manifestations of head trauma.
OBJECTIVE
To describe the neuro-ophthalmic findings in a group of patients with head trauma.


METHODS
A retrospective chart review of all patients given a diagnosis code of head trauma in the neuroophthalmology unit at Emory University between 1991 and 1999.


RESULTS
A total of 326 consecutive patients were reviewed (203 [63%] men and 123 [37.0%] women). Age ranged from 2 to 86 years, with a mean of 30 years. Motor vehicle accident was the most common cause of head trauma, occurring in 195 (59.8%) patients. An abnormal neuro-ophthalmic examination was noted in 185 of 326 patients (56.7%). Loss of consciousness was not associated with any outcome, but the presence of a neuroimaging abnormality, particularly intracranial hemorrhage, was significantly associated with specific neuroophthalmic deficits.


CONCLUSIONS
Head trauma causes a number of neuroophthalmic manifestations. The afferent and efferent pathways are vulnerable to traumatic injury, although the efferent system is more commonly affected. Loss of consciousness may not be a reliable predictor of specific neuro-ophthalmic outcomes, but neuroimaging abnormalities may.
Van Stavern
G P
GP
Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia, USA.
Biousse
V
V
Lynn
M J
MJ
Simon
D J
DJ
Newman
N J
NJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001766:Blindness / Q000209:etiology; D001930:Brain Injuries / Q000150:complications* / Q000175:diagnosis; D002648:Child; D002675:Child, Preschool; D004172:Diplopia / Q000209:etiology; D005128:Eye Diseases / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000175:diagnosis / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors