Neuro-Ophthalmic Manifestations of Head Trauma-A Critical Review
This research article, named, Neuro-Ophthalmic Manifestations of Head Trauma was written by Van Stevern, Gregory P. MD, Biousse, Valerie MD, Lynn, Michael J. MS, Simon, Deborah J. MD, Newman and Nancy J. MD. It was published in the Volume 21 of Journal of Neuro-Ophthalmology, on June 2nd, 2001, covering pages 112 to 117.
It is a proven concept that the head injury, most frequently leads to the neuro-ophthalmic defects, but a very little work has been done yet to precisely describe the frequency of various defects that occurs in different groups of patients suffering from the head injuries. This study basically covers this aspect. It includes in it the evaluation of data collected from the Evary University. After careful history and examination, and observing the damages resulting from head injury in these patients, different charts were developed. These charts describe the percentage of patients according to the causes of their head trauma, any associated findings and the frequency of the neuro-ophthalmic deficits; including the afferent and efferent pathway deficits.
The study results suggest that the indirect traumatic optic neuropathy should not be missed in the patients with severe head trauma. Traumatic chiasmal injury showed a very low frequency. The retrichiasmal visual field defects showed a relatively higher incidence. The trochlear nerve also showed a relatively higher frequency of damage. Likewise, convergence insufficiency was found to occur in a large number of these observed patients. Besides the above mentioned results, the results explained that the loss of consciousness shows a relative severe head injury, but does not depict any specific type of neuro-ophthalmic disorder to occur. However, a definite relationship between an intracranial hemorrhage and unilateral occulomotor palsy was shown. Similarly, the skull fractures showed a relevance with the abducens nerve palsy. But it is also described in the end that, about one-third of the observed patients were found to have normal neuro-imaging, yet having certain neuro-ophthalmic findings. So, having a normal neuro-imaging does not rule out the presence of neuro-ophthalmic abnormalities.
After reviewing this research article, we can say that it is a well researched study, covering a good aspect in the field of head injuries. Describing the relationship between frequency of a disorder and the type of injury makes it easier to reach an early diagnosis of complications and providing better treatment to the patient. Although, the results do not appear to exactly pin point the occurrence of a particular neuro-ophthalmic disorder, for a certain type of head injury, yet they do give a gross idea about it.