J Korean Ophthalmol Soc.  2005 Mar;46(3):422-428.

Neuro-Ophthalmic Manifestations of Head Trauma and Predictive Factors

• Lee DW

Abstract

PURPOSE
To describe the neuro-ophthalmic findings in a group of patients with head trauma. METHODS: A retrospective chart review of all patients who were given a diagnosis code of cerebral concussion and cerebral contusion in a hospital between 1995 and 2003. A total of 1284 consecutive patients were reviewed (972 [76%] men and 312 [24%] women). The mean age was 40.36 years. Motor vehicle accident was the most common cause of head trauma, occurring in 944 (74%) patients. RESULTS: Ophthalmological examination was undertaken in 308 (24%) head trauma patients and an abnormal neuro-ophthalmic examination result was noted in 122 patients (9.5% of total patients, 40% of ophthalmologically examined patients). Traumatic optic neuropathy was the most common manifestation, followed by oculomotor, abducens, trochlear, facial nerve palsy, Terson syndrome and internuclear ophthalmoplegia. Loss of consciousness and cerebral concussion were not associated with any outcomes, but the presence of neuroimaging (computed tomography, magnetic resonance imaging) abnormality, particularly intracranial hemorrhage and skull fracture, was significantly associated with neuro-ophthalmic deficits. CONCLUSIONS: Head trauma causes a number of neuro-ophthalmic manifestations. Intracranial hemorrhage and skull fracture may be a reliable predictor of specific neuro-ophthalmic outcomes.

Keyword

Head trauma; Loss of consciousness; Neuroimaging abnormality; Neuro-ophthalmic findings

MeSH Terms

Brain Concussion
Contusions
Craniocerebral Trauma*
Diagnosis
Facial Nerve
Head*
Humans
Intracranial Hemorrhages
Male
Motor Vehicles
Neuroimaging
Ocular Motility Disorders
Optic Nerve Injuries
Paralysis
Retrospective Studies
Skull Fractures
Unconsciousness