No abstract

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.