Serova N K, Lazareva L A, Eliseeva N M, Eolchiian S A
Vestn Oftalmol. 1994 Jul-Sep;110(3):10-1.
Craniocerebral injuries are known to involve the visual tract in 2-5% of cases. Fifty-nine patients aged 5 to 68 with visual tract involvement in craniocerebral injury were examined in N. N. Burdenko Institute of Neurosurgery of the Russian Academy of Medical Sciences. Unilateral optic nerve involvement was found in 48 patients, involvement of the chiasm and/or both optic nerves in 11. Involvement of a single optic nerve was associated with vision acuity reduction, 30 patients becoming blind or virtually blind, and with various defects of the visual field. Traumatic injury to the chiasm manifested as a rule by the asymmetric chiasmal syndrome. Follow-up of the patients in the acute period of craniocerebral injury showed that paling of the optic disc manifested in various periods after the moment of the injury, from 3-4 days to 1 month, this depending on the localization of the injury and its distance from the posterior pole of the eye. Besides visual disturbances and ophthalmoscopic changes, oculomotor disorders were found which were caused by traumatic impairment of the oculomotor nerves (in the orbit or skull) and muscles. Transcutaneous electrostimulation of the injured optic nerves was sufficiently effective, its efficacy directly depending on the period elapsed since the injury, excepting blind or virtually blind patients.
已知颅脑损伤在2%至5%的病例中累及视路。俄罗斯医学科学院N. N. 布尔坚科神经外科研究所对59例年龄在5至68岁、视路受累的颅脑损伤患者进行了检查。发现48例患者单侧视神经受累，11例患者视交叉和/或双侧视神经受累。单条视神经受累与视力下降有关，30例患者失明或几乎失明，还伴有各种视野缺损。视交叉创伤性损伤通常表现为不对称的视交叉综合征。对颅脑损伤急性期患者的随访表明，视盘苍白在受伤后3至4天到1个月的不同时期出现，这取决于损伤的部位及其与眼球后极的距离。除了视觉障碍和眼底镜检查变化外，还发现了动眼神经障碍，这是由动眼神经（在眼眶或颅骨内）和肌肉的创伤性损伤引起的。对受伤视神经进行经皮电刺激足够有效，其疗效直接取决于受伤后的时间，但失明或几乎失明的患者除外。
