Megadose Steroids and Intranasal Optic Nerve Decompression in the Treatment of Traumatic Optic Neuropathy
Journal of Rhinology
;
: 136-139, 1999.
Artigo
em Inglês
| WPRIM
| ID: wpr-174497
ABSTRACT
BACKGROUND AND OBJECTIVES:
Traumatic optic neuropathy (TON) is a relatively rare complication associated with closed head injury. However, it represents an extremely poor prognosis, and its management remains controversial. We present the treatment results of 15 patients with immediate and complete TON who were treated with megadose steroids (MDS), and, in cases where MDS produced no response, intranasal optic nerve decompression (OND). PATIENTS ANDMETHODS:
The diagnosis of TON was based on evidence of the following complete loss of vision, absence of direct pupillary light reflex and intact consensual response. All of the patients underwent high resolution CT scans of the orbit and received a complete neuro-opthalmologic examination. MDS was started immediately after the diagnosis. If no response occurred by 48 hours, an intranasal OND was conducted.RESULTS:
Two of the 15 patients exhibited improved vision after treatment with MDS, and six of the remaining 13 patients who were unresponsive to MDS demonstrated improved vision after OND. Overall, eight out of the 15 patients experienced improved vision.CONCLUSION:
This study is uncontrolled, but suggests that our protocol of MDS and, in cases where this produced no response, OND may be an effective and valid treatment modality for patients with immediate complete TON, which is generally believed to represent an extremely poor prognosis regardless of treatment.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Nervo Óptico
/
Órbita
/
Prognóstico
/
Reflexo
/
Esteroides
/
Tomografia Computadorizada por Raios X
/
Traumatismos Cranianos Fechados
/
Traumatismos do Nervo Óptico
/
Descompressão
/
Diagnóstico
Tipo de estudo:
Estudo diagnóstico
/
Guia de Prática Clínica
/
Estudo prognóstico
Limite:
Humanos
Idioma:
Inglês
Revista:
Journal of Rhinology
Ano de publicação:
1999
Tipo de documento:
Artigo
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