Ulus Travma Acil Cerrahi Derg. 2016; 22(1): 97-99 | DOI: 10.5505/tjtes.2015.90540

Isolated Bitemporal Hemianopsia Due to Traumatic Chiasmal Syndrome

Bülent Yazýcý, Sertaç Argun Kývanç
Department Of Ophthalmology, Uludag University, Bursa, Turkey

A 20-year old man presented with complaints of inability to see the outer half of objects and blurred near vision when 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.

Keywords: Bitemporal hemianopsia, head trauma, optic chiasmal injury, traumatic chiasmal syndrome

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Travmatik Kiyazmal Sendroma Baðlý Izole Bitemporal Hemianopsi

Bülent Yazýcý, Sertaç Argun Kývanç
Uludað Üniversitesi Göz Hastalýklarý Anabilim Dalý, Bursa

Yirmi yaþýnda, erkek hasta her iki gözünde nesnelerin yarýsýný görememe ve okurken bulanýk görme yakýnmalarýyla baþvurdu. Hastanýn yakýnmalarý bir yýl önce kranyo-orbital kýrýklara yolaçan bir trafik kazasýndan sonra baþlamýþtý. Göz muayenesinde total bitemporal hemianopsi ve hafif ekzotropya saptandý. Görme keskinlikleri her iki gözde 1.0’dý. Radyolojik incelemede fronto-etmoid ve sfenoid kemiklerde kýrýklar ve optik kiyazmada incelme saptandý. Hipotalamo-hipozifer bir bozukluk saptanmadý. Ýzlem sýrasýnda görsel bulgularda deðiþiklik olmadý. Nadir olmakla birlikte, künt kafa travmasý kiyazmal çaprazlaþan sinir demetlerinde izole bir hasara ve buna baðlý olarak normal görme keskinliðinin eþlik ettiði bir bir bitemporal hemianopsiye yol açabilir. Travmatik kiyazmal sendrom bitemporal hemianopsinin ayýrýcý tanýsýnda göz önünde tutulmalýdýr.

Anahtar Kelimeler: Bitemporal hemianopsia, kafa travmasý, optik kiyazmal yaralanma, travmatik kiyazmal sendrom

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