Yamamoto L G, Bart R D
Department of Pediatrics, University of Hawaii John A. Burns School of Medicine, Honolulu.
Clin Pediatr (Phila). 1988 Oct;27(10):479-83. doi: 10.1177/000992288802701003.
A series of seven children in Hawaii experienced transient cortical blindness following mild head trauma. All children, ages 3 through 8, recovered fully. The most prominent clinical feature was initial restlessness and agitation following relatively mild head trauma without significant loss of consciousness (LOC). One child may have experienced this several times. The clinical features associated with a benign outcome in this syndrome include: pediatric age group, mild head trauma, brief or no LOC, onset of blindness occurring within hours of the head injury, absent optokinetic nystagmus, duration of blindness less than 24 hours, agitation and restlessness, absence of skull fracture or visible cerebral injury on CT scan, absence of other neurological deficits, and EEG findings that initially show posterior slowing with subsequent normalization. Transiently fixed and dilated pupils have been described in these patients but should be viewed cautiously by clinicians in making this diagnosis, since cortical blindness is defined by sparing of the pupils. This syndrome may be underdiagnosed, since it may not be obvious that the child is blind unless the diagnosis is considered.
夏威夷的一系列7名儿童在轻度头部外伤后经历了短暂性皮质盲。所有儿童年龄在3至8岁之间，均完全康复。最突出的临床特征是在相对轻度的头部外伤后最初出现烦躁不安，且无明显意识丧失（LOC）。一名儿童可能经历过几次这种情况。该综合征预后良好的相关临床特征包括：儿童年龄组、轻度头部外伤、短暂或无LOC、失明在头部受伤后数小时内出现、无视动性眼球震颤、失明持续时间少于24小时、烦躁不安、CT扫描无颅骨骨折或可见脑损伤、无其他神经功能缺损以及脑电图结果最初显示后部减慢随后恢复正常。这些患者中曾有过短暂性固定和散大瞳孔的描述，但临床医生在做出此诊断时应谨慎看待，因为皮质盲的定义是瞳孔不受影响。该综合征可能诊断不足，因为除非考虑到该诊断，否则可能不明显孩子是失明的。
