Traumatic Chiasmal Syndrome Associated with Anosmia, Pneumocephalus and Sella Fracture

Nimitr Itthipunkul, M.D.*
Watana Navacharoen, M.D.*
Department of Ophthalmology, Faculty of Medicine, Chiangmai University.

    Abstract A 22-year-old man sustained severe had injury, including a brief loss of consciousness, in a motorcycle accident. Skull X-ray films disclosed a fracture of the right orbital rim. Computed tomography demonstrated pneumocephalus and extension of the fracture into the sella turcica. Perimetric testing enclosed a bitemporal hemianopia along the vertical meridian. Visual acuity was 6/6-3, 6/36 in right and left eyes, respectively, with relative afferent pupillary defect in left eye. Anosmia was detected in both sides. Diplopia was attributed due to injury of the right inferior oblique muscle and to the effect of bitemporal field loss. There was no evidence of pituitary dysfunction. No treatment of the patient’s visual loss was undertaken. A six-month follow-up examination disclosed no change in the patient’s visual field abnormalities.

Thai J Ophthalmol 1987 December; 1(2):72-75.