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Visual field constriction in a case of cerebrospinal fluid hypovolemia following traffic accident Kayo Suzuki 1 , Akihiro Takahashi 2 , Yasuhiro Shinmei 1 , Yoshiaki Tagawa 1 , Mayo Nozaki 1 , Kan Ishijima 1 , Shinki Chin 1 , Susumu Ishida 1 1Department of Ophthalmology, Hokkaido University Graduate School of Medicine 2Higashi-Sapporo Neurology and Neurosurgery Clinic pp.301-307
Published Date 2017/3/15
DOI https://doi.org/10.11477/mf.1410212181
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Abstract Purpose:To report a case who developed visual field constriction presumably due to cerebrospinal fluid(CSF)hypovolemia following traffic accident.

Case:A 28-year-old male suffered blunt trauma to the head and neck after hitting a tree while driving. Corrected visual acuity was 0.4 right and 1.2 the following day. He visited us after impairment of vision one month later.

Findings and Clinical Course:Corrected visual acuity was hand motion right and 0.07 left. Both eyes showed constricted visual field. The left eye showed central scotoma. The fundus in both eyes appeared normal. Magnetic resonance imaging(MRI)showed normal findings in the brain and orbits. Vision and visual field remained unchanged during the ensuing 7 months. CSF hypovolemia was suspected after the visual function improved following intravenous infusion of electrolytes. Lumbar puncture showed normal CSF pressure. Radioisotope cisternography showed no CSF leakage but accelerated radioisotope clearance. He was diagnosed with CSF hypovolemia. Epidural patch was followed by improved visual acuity, visual field, and other systemic manifestations.

Conclusion:Constriction of visual field and impaired visual acuity appeared to be secondary to CSF hypovolemia. Epidural blood patch was effective for visual manifestations.


Copyright © 2017, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1308 印刷版ISSN 0370-5579 医学書院

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