Visual disorders after traumatic brain injury in children

E. Castelli, G. Poggi, G. Mancarella

Research output: Contribution to journalArticle

Abstract

Objectives. To determine the neuroophthalmological disorders in post-traumatic children, investigating possible correlations with age at trauma, clinical parameters in the acute phase, neuroimaging data and outcome with the aim to identify possible risk factors for the development of these deficits and their effects on the rehabilitation planning. Methods. Fifty-six head-injured children without pre-traumatic visual disorders and a Glasgow Coma Scale (GCS) motor score of 6 were selected. We collected pre-traumatic visual skills, age at trauma, and clinical and neuroimaging data in the acute phase. All patients underwent complete neurological and neuroophthalmological assessment and MRI follow-up. Outcome was assessed by the Glasgow Outcome Scale (GOS). Results. Mean age at trauma was 6.8+3.3; the mean GCS score was 6.1+2.5; and the mean duration of coma was 4.4+4.2 weeks. Of these children 55.5% had a vision <14/20 and 93% had frontal lobe lesions. The more severe vision impairment was associated with total or partial optic nerve atrophy. A total of 50% presented with a convergence deficit, 41.1% a fixation, saccades and pursuit alterations, 33.9% a nistagmus and 44.6% a visual field deficit. The mean GOS score was 2.4+1.9. Among the acute or subacute phase parameters only duration of coma was associated with all visual disorders. A greater frequency of vision, fundus and oculo-motor alterations was present in the younger age group, whereas a convergence deficit prevailed in the older age group. Conclusions. Our study shows that at a developmental age there is a high incidence of visual complexity and variabile disorders following trauma, and duration of the coma is the main risk factor conducive to their occurrence.

Original languageEnglish
JournalNeurological Sciences
Volume21
Issue number4 SUPPL.
Publication statusPublished - 2000

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Neurology

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