Clinical Investigation Of Traumatic Lesions On Posterior Visual Pathway

Object:Traumatic lesions of the posterior visual pathway are rare in clinical practice, often associated with skull fractures or intracranial hemorrhage, it's difficult for early diagnosis, This article retrospective analyzes the past 5 years in the General Hospital of PLA after the treatment of traumatic lesions of the visual pathway of the clinical data of patients, analyze the etiology, clinical manifestations, imaging features and prognosis, so early diagnosis and early treatment is important for the protection of visual function.Method:Select the traumatic brain injury patients from January 2006 to December 2010 received treatment in the PLA General Hospital, a total of 65 people, analyze the relevant factors, including the general condition of patients (sex, age), cause of injuries, injury site, Changes of the visual field, imagings and treatment outcomes. After the statistical analysis, it will be obtained a good age, sex, the main reason for injuries, the type of common visual field defect and imaging features, the relevance of the recovery rate of the visual field and the course of the disease.Results:1. The patients of traumatic lesions on the posterior visual pathway age 31 to 40 majority, accounting for 46.2%, of which more male patients, 43 cases, accounting for 66.2%, 22 cases of female patients, accounting for 33.8%, sex proportion of male and female patients was 1.9:1.2. visual field defect: The non-overlapping with the hemianopia in 35 (53.8%), overlapping with the hemianopia in 21 cases (32.3%), cortical blindness in 8 cases (12.3%), eyes with central scotoma to the hemianopia of 1 case (1.6%). Cases of 65 patients, 14 patients (21.5%) macular evasion.3. visual field defect and damage parts of the relationship: optic tract injury accounted for 5 cases (7.7%), the performance of non-overlapping with the hemianopia; no lateral geniculate body injury; optic radiation injury accounted for 11 cases (16.9%) , 6 (9.2%) of non-overlapping with the hemianopia, 5 patients (7.7%) were overlapping with the hemianopia, 3 cases (4.6%) showed macular avoided; occipital lobe injury accounted for 20 cases (30.8% ), 4 cases (6.2%) non-overlapping with the hemianopia, 9 patients (13.9%) were overlapping with the hemianopia, 6 patients (9.2%) were cortical blindness, and 1 case (1.5%) of the hemianopia central scotoma, 8 cases (12.5%) showed macular avoided; multiple injuries accounted for 29 cases (44.6%), 20 patients (30.8%) non-overlapping with the hemianopia, 7 patients (10.8%) were overlapping with the hemianopia, 2 cases (3.0%) were cortical blindness, in which 3 cases of macular avoidance (4.6%).4. the relationship between vision improved after treatment and the course of disease: 65 cases were based on the course of disease divided into 4 groups. The results showed: Group I: the course of disease≤1 month, vision improved after treatment in 19 patients (29.2%), not improved in 2 cases (3.1%); the second group: the course of disease> 1,≤3 months ,vision improved in 15 cases (23.1%), no improvement in 3 cases (4.6%); the third group: the course of disease> 3,≤6 months, vision improved in 7 cases (10.8%), no improvement in 8 cases (12.3% ); fourth group: the course of disease> 6 months, vision improved in 5 cases (7.7%), not improved in 6 cases (9.2%). Total of 46 patients (70.8%) vision improved in 19 patients (29.2%) did not improve vision. First and second groups the difference was not statistically significant (P> 0.05), between the second and the third group, the difference was statistically significant (χ2 = 3.438, P <0.05), between the third group and the fourth group, the difference was not statistically significant (P> 0.05). Between vision improved within 3 months and more than 3 months, the difference was statistically significant (χ2 = 10.787, P <0.05).Conclusions:1. It is common for 31 to 40-year-old young men of lesions on the posterior visual pathway in trau matic brain injury, incentives more common in road accident.2. Traumatic lesions of the posterior visual pathway are more likely to result in patients with visual field damage, can occur with different types of visual field changes, common to the non-overlapping with the hemianopia.3. it is positive for patients early given the treatment of neurotrophic and microcirculation, and given within 3 months, the visual field will be more likely to recover.