ABSTRACT
Cortical blindness [C.B] is a specific form of cerebral blindness associated with a lesion of the geniculo-striated optical ways. The interest of our case is to emphasise on the physiopathological mechanisms associated with this affection and its traumatic origin. This is a 42 years old patient, a victim of a traffic accident with multiple pelvic, forearm fractures and cranio-facial traumatism with exception to the orbits. The initial examination showed a loss of consciousness [Glascow Coma Scale 10] without any associated neurological deficit. The cerebral TDM documented bilateral diffuse occipital hypodensity with mass effect on median structures, without associated bone fractures. 72 hours later in the intensive care unit, she regained consciousness and increased intracranial pressure syndrome associated with complete bilateral blindness without any other localized sign was found. The evolution was satisfying as a result of early introduction of an anticoagulant treatment with a complete vision recovery. The etiology of the cerebral blindness is various. However, the post traumatic origin is rare. In our case, this association is original and opens new ways of research focusing its physiopathology in order to establish an early treatment and to ameliarate the visual prognosis
Subject(s)
Humans , Male , Wounds and Injuries , Brain Ischemia , Craniocerebral Trauma , Blindness, Cortical/diagnosisABSTRACT
Transient visual loss may occur with occipital seizures as an ictal or post-ictal phenomenon. Its duration varies from less than one minute to days, or can be permanent. We describe a 61-year-old man presenting with headache, vomiting and bilateral visual loss. EEG revealed persistent spike discharge in the occipital lobes suggesting occipital seizures. His vision improved with carbamazepine.
Subject(s)
Anticonvulsants/administration & dosage , Blindness, Cortical/diagnosis , Carbamazepine/administration & dosage , Electroencephalography , Epilepsies, Partial/complications , Functional Laterality , Humans , Male , Middle AgedABSTRACT
O Objetivo deste trabalho é relatar dois casos de cegueira cortical atendidos no serviço de urgência da Clínica de Olhos de Santa Casa de Belo Horizonte. A cegueira cortical é uma condiçäo clínica rara e bilateral, de causa isquêmica, caracterizada por lesäo no córtex cerebral. nos presentes casos, o diagnóstico foi feito pela sintomatologia clínica, pelos achados oftalmológicose pelas alteraçöes obtidas por imagem. Em ambos houve evoluçäo rápida da doença, como perda visual súbita importante. O acompanhamento oftalmológico näo revelou melhora significativa da acuidade visual final. A baixa acuidade visual é um sinal importante em oftalmologia e deve ser avaliada com cautela e atençäo, visto que pode ser causada pela cegueira cortical, condiçäo rara, grave e ainda pouco estudada no nosso meio.