Sabates N R, Gonce M A, Farris B K
Massachusetts Eye and Ear Infirmary, Boston.
J Clin Neuroophthalmol. 1991 Dec;11(4):273-7.
Visual abnormalities following closed head trauma are common and can affect any part of the visual pathway. We reviewed 181 consecutive patients referred with visual complaints following closed head trauma. A motor vehicle accident was the most common etiology of trauma in 57% of cases, direct trauma to the head in 15%, and injuries sustained from a fall in 13%. Sixty-three percent of patients lost consciousness and 26% suffered a skull fracture. Thirty-five percent of all patients had visual field defects with functional (tunnel) fields the most common. Over 88% of eyes had 20/20 or better visual acuity. Thirty-three percent of patients suffered a cranial nerve palsy, with 75% resolving without intervention. The severity of head injury was directly related to the lack of proper seat belt and helmet use. Most visual complaints were improved with a simple refraction. Most binocular diplopia cleared with time, with only 15 cases requiring surgical correction.
闭合性颅脑损伤后的视觉异常很常见，可影响视觉通路的任何部位。我们回顾了181例因闭合性颅脑损伤后出现视觉症状而转诊的连续患者。在57%的病例中，机动车事故是最常见的创伤病因，15%为头部直接创伤，13%为跌倒所致损伤。63%的患者失去意识，26%的患者发生颅骨骨折。所有患者中有35%存在视野缺损，其中功能性（管状）视野最为常见。超过88%的眼睛视力为20/20或更好。33%的患者患有颅神经麻痹，其中75%未经干预即恢复。头部损伤的严重程度与未正确使用安全带和头盔直接相关。大多数视觉症状通过简单的验光即可改善。大多数双眼复视会随着时间自行消失，只有15例需要手术矫正。
