Bitemporal hemianopsia after skullbase fracture: acase report Takuro HAYASHI 1,2 , Hiroki WAKAMOTO 1 , Yoshinori SHIMAMOTO 1 , Hiromichi MIYAZAKI 1 , Naomi ISHIYAMA 1 1Department of Neurosurgery, Hiratsuka City Hospital Keyword: traumatic chiasmal syndrome , bitemporal hemianopsia , skull bas fracture pp.1021-1025
Published Date 1997/11/10
DOI https://doi.org/10.11477/mf.1436901483
  • Abstract
  • Look Inside

We report a case of bitemporal hemianopsia after skullbase fracture.

An 18-year-old male presented with frontal head hit due to a traffic accident. Consciousness level on admis-sion was JCS 10. Initial CT scan revealed traumatic SAH and pneumocephalus. We treated him conserva-tively. Ten hours after the accident, consciousness level went down, and CT imaging disclosed bilateral frontal hemorrhage. The three dimensional CT (3D-CT) imag-ing showed two fracture lines from the roof of the ethmoid sinus to the planum sphenoidale. Although his consciousness improved gradually, he complained of rhinorrhea, anosmia and double vision. On pre-operative visual field examination, bitemporal hemi-anopsia was noticed. Repair operation for CSF rhinor-rhea was performed. Operative findings revealed two fracture lines corresponding to the 3D-CT scan. The optic chiasm was compressed by the tuberculum sellae. We could not find obvious tearings or stretchings of the chiasm.

Reports on operative findings of traumatic chiasmal syndrome are rare, and most of the reports presume that bitemporal hemianopsia results from tearing or stretching of the chiasm. We could confirm that, in some cases, bitemporal hemianopsia could result from direct pressure of the tuberculum sellae.

Copyright © 1997, Igaku-Shoin Ltd. All rights reserved.


電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院