[Reversible post traumatic cortical blindness]

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