title: Evaluation of transcranial surgical decompression of the optic canal as a treatment option for traumatic optic neuropathy.
abstract: OBJECTIVE
  Traumatic optic neuropathy (TON) is a serious complication of head trauma, with the incidence rate ranging from 0.5% to 5%. The two treatment options widely practiced for TON are: (i) high-dose corticosteroid therapy and (ii) surgical decompression. However, till date, there is no consensus on the treatment protocol. This study aimed to evaluate the therapeutic efficacy of transcranial decompression of optic canal in TON patients.
  
  
  METHODS
  A total of 39 patients with visual loss resulting from TON between January 2005 and June 2013 were retrospectively reviewed for preoperative vision, preoperative image, visual evoked potential (VEP), surgical approach, postoperative visual acuity, complications, and follow-up results.
  
  
  RESULTS
  All these patients underwent transcranial decompression of optic canal. During the three-month follow-up period, among the 39 patients, 21 showed an improvement in their eyesight, 6 recovered to standard logarithmic visual acuity chart "visible," 10 could count fingers, 2 could see hand movement, and 3 regained light sensation.
  
  
  CONCLUSIONS
  Visual evoked potential could be used as an important preoperative and prognostic evaluation parameter for TON patients. Once TON was diagnosed, surgery is a promising therapeutic option, especially when a VEP wave is detected, irrespective of the HRCT scan findings. Operative time between trauma and operation is not necessary reference to assess the therapeutic effect of surgical decompression. The poor results of this procedure may be related to the severity of optic nerve injury. The patient's age is an important factor affecting the surgical outcomes.
authors.affiliation: Department of Neurosurgery & Institute of Neurology, Lanzhou University Second Hospital, Lanzhou, Gansu Province 730030, People's Republic of China. Electronic address: leohe1981@hotmail.com.
authors.forename: Zhenhua
authors.initials: Z
authors.lastname: He
authors.affiliation: Department of Neurosurgery & Institute of Neurology, Lanzhou University Second Hospital, Lanzhou, Gansu Province 730030, People's Republic of China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Li
authors.affiliation: Pain Department, Lanzhou University Second Hospital, Lanzhou, Gansu Province 730030, People's Republic of China.
authors.forename: Jingmin
authors.initials: J
authors.lastname: Yuan
authors.affiliation: Department of Neurosurgery & Institute of Neurology, Lanzhou University Second Hospital, Lanzhou, Gansu Province 730030, People's Republic of China. Electronic address: zhangxinding@126.com.
authors.forename: Xinding
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Anesthesiology Department, Lanzhou University Second Hospital, Lanzhou, Gansu Province 730030, People's Republic of China.
authors.forename: Ruiping
authors.initials: R
authors.lastname: Gao
authors.affiliation: Department of Neurosurgery & Institute of Neurology, Lanzhou University Second Hospital, Lanzhou, Gansu Province 730030, People's Republic of China.
authors.forename: Yanming
authors.initials: Y
authors.lastname: Han
authors.affiliation: Department of Neurosurgery & Institute of Neurology, Lanzhou University Second Hospital, Lanzhou, Gansu Province 730030, People's Republic of China.
authors.forename: Wenzhen
authors.initials: W
authors.lastname: Yang
authors.affiliation: Department of Neurosurgery & Institute of Neurology, Lanzhou University Second Hospital, Lanzhou, Gansu Province 730030, People's Republic of China.
authors.forename: Xuefeng
authors.initials: X
authors.lastname: Shi
authors.affiliation: Department of Neurosurgery & Institute of Neurology, Lanzhou University Second Hospital, Lanzhou, Gansu Province 730030, People's Republic of China.
authors.forename: Zhengbo
authors.initials: Z
authors.lastname: Lan
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D015331:Cohort Studies; D019299:Decompression, Surgical / Q000379:methods*; D005074:Evoked Potentials, Visual / Q000502:physiology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D020221:Optic Nerve Injuries / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D011379:Prognosis; D012189:Retrospective Studies; D061665:Time-to-Treatment; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014792:Visual Acuity; D055815:Young Adult
keywords: Operative time; Pterional transsylvian approach; Transcranial decompression of optic canal; Traumatic optic neuropathy; Visual evoked potential