Total Avulsion of the Eye Globe Combined with an Injury of the Chiasm – a Case Report

Czech version

Authors: L. Hejsek ¹; V. Kaňa ¹; P. Rozsíval ¹; J. Dusová ¹; A. Stepanov ¹; P. Trávníček ²; L. Tuček ³
Authors‘ workplace: LF UK a FN Hradec Králové Oční klinika ¹; LF UK a FN Hradec Králové Neurochirurgická klinika ²; LF UK a FN Hradec Králové Stomatologická klinika ³
Published in: Cesk Slov Neurol N 2014; 77/110(4): 510-514
Category: Case Report

Práce byla prezentována 15. 10. 2013 na mezinárodním kongresu Pražský oční festival, kde byla hodnocena jako nejlepší přednáška kongresu.

Overview

The authors report a rare case of complete traumatic avulsion of the eyeball with the optic nerve at the level of chiasm. The case report retrospectively describes a year-long monitoring of a young woman who was injured in fire-fighter races. Avulsion of the globe and optic nerve combined with injured chiasm resulted in contralateral hemianopic visual field defect. The trauma led to subarachnoid hemorrhage in cisterns of chiasm, which spontaneously resolved. There was no development of vascular spasms in the brain. Systemic corticosteroid therapy and neuroprotection did not affect the course of the disease. During the observation period, descending atrophy of the corresponding axons and retinal ganglion cells developed. There is currently no effective therapy of chiasm injuries.

Key words:
globe avulsion – optic nerve avulsion – hemianopsia – trauma

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