title: Isolated bitemporal hemianopsia due to traumatic chiasmal syndrome.
abstract: A 20-year-old man presented with complaints of inability to see the outer half of objects and blurred near vision while reading. His complaints began one year ago after a motor vehicle accident that caused cranio-orbital fractures. Ocular examination revealed complete bitemporal hemianopsia and slight exotropia. Central visual acuity was 20/20 in both eyes. Radiologic studies demonstrated fractures in the fronto-ethmoid and sphenoid bones and thinning of the optic chiasm. No hypothalamic-pituitary abnormality was detected. Clinical findings remained unchanged during follow-up. Although rare, blunt head trauma may cause an isolated damage to the chiasmal crossing nerve fibers, resulting in a complete, bitemporal hemianopsia associated with normal visual acuity. Traumatic chismal syndrome should be considered in the differential diagnosis of patients presenting with bitemporal hemianopsia.
authors.affiliation: Department of Ophthalmology, Uludağ University Faculty of Medicine, Bursa, Turkey. byazici@uludag.edu.tr.
authors.forename: Bulent
authors.initials: B
authors.lastname: Yazici
authors.affiliation: Department of Ophthalmology, Uludağ University Faculty of Medicine, Bursa, Turkey.
authors.forename: Sertac Argun
authors.initials: SA
authors.lastname: Kivanc
mesh_terms: D000063:Accidents, Traffic; D003937:Diagnosis, Differential; D016489:Head Injuries, Closed / Q000150:complications*; D006423:Hemianopsia / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D009897:Optic Chiasm / Q000293:injuries*; D009901:Optic Nerve Diseases / Q000175:diagnosis* / Q000209:etiology; D009917:Orbital Fractures / Q000150:complications*; D013577:Syndrome; D055815:Young Adult