Intrachiasmal hemorrhage

Abstract

A 49-year-old man presented with blurred vision 9 days following frontal head trauma. Visual loss progressed to bilateral blindness. Magnetic resonance imaging revealed hemorrhage and swelling within the optic nerves and chiasm. Indirect trauma to the anterior visual pathways may cause delayed blindness due to hemorrhage and edema within these structures.

Surgical decompression in traumatic optic neuropathy

“…Less commonly, injury may occur in the intracranial portion of the nerve, or at the optic chiasm (Hughes 1962; Walsh 1966; Park et al. 1971; Crowe et al. 1989; Steinsapir & Goldberg 1994).…”

“…Although its record for demonstrating bony fractures is poor, MRI may demonstrate haematoma or even haemorrhage within the optic nerve sheath (Crowe et al. 1989).…”

Advanced Trauma Life Support (ATLS) and facial trauma: can one size fit all? Part 4: ‘Can the patient see?’ Timely diagnosis, dilemmas and pitfalls in the multiply injured, poorly responsive/unresponsive patient

“…Although in most instances loss of sight occurs immediately following injury, delayed visual loss has been well documented 21,33 , in some cases up to 2 weeks following the initial injury 19,72 . ATLS teaches that in all injured patients regular reassessment is necessary to identify evolving problems.…”

Optic Neuropathy with Delayed Onset After Trauma: Case Report and Review of the Literature

“…Delayed TON likely represents a heterogeneous group of mechanisms. Crowe and colleagues described a patient with vision loss starting nine days after frontal head trauma due to hemorrhage and swelling within the optic nerve and chiasm 3 . Markus and colleagues also described a case of delayed TON that developed in a sixteen-year old female two months after blunted head trauma.…”