Damage to the optic chiasm is an unusual sequela to head injury. Especially interesting and rare is the lesion which simulates a sagittal section of the chiasm. The precise pathophysiology of this occurrence is still subject to discussion.
Report of Case
In April, 1959, the patient, a 20-year-old white man, was injured in an automobile accident, striking his head and losing consciousness for an undetermined period of time. Examination by a neurosurgeon following the injury revealed no neurological abnormalities other than slight confusion and disorientation. There was a small laceration in the right frontal area and marked bilateral periorbital edema and ecchymosis.Fluid was thought to be behind the eardrums, giving rise to a suspicion that a basilar skull fracture might be present.A lumbar puncture revealed a cerebrospinal fluid pressure of 240 mm. of water. There were 290,000 red blood cells per cubic millimeter and an elevated total protein.
Wuest FC. Bitemporal Hemianopsia Following a Traumatic Lesion of the Optic Chiasm. AMA Arch Ophthalmol. 1960;63(4):721-723. doi:10.1001/archopht.1960.00950020723016