Neuro-ophthalmic manifestations of head trauma

Objective: To describe the neuro-ophthalmic findings in a group of patients with head trauma. Materials and Methods: A retrospective chart review of all patients given a diagnosis code of head trauma in the neuroophthalmology unit at Emory Univ ersity between 1991 and 1999. Results: A total of 326 consecutive patients were reviewed (203 [63%] men a nd 123 [37.0%] women). Age ranged from 2 to 86 years, with a mean of 30 yea rs. Motor vehicle accident was the most common cause of head trauma. occurr ing in 195 (59.8%) patients. An abnormal neuro-ophthalmic examination was n oted in 185 of 326 patients (56.7%). Loss of consciousness was not associat ed with any outcome, but the presence of a neuroimaging abnormality, partic ularly intracranial hemorrhage. was significantly associated with specific neuroophthalmic deficits. Conclusions: Head trauma causes a number of neuroophthalmic manifestations. The afferent and efferent pathways are vulnerable to traumatic injury. alt hough the efferent system is more commonly affected. Loss of consciousness may not be a reliable predictor of specific neuro-ophthalmic outcomes, but neuroimaging abnormalities may.