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Total blindness after trival frontal head trauma

Bilaterall ilndirect optic nerve injury

Department of Ophthalmology, Homer G. Phillips Hospital; The Edward Mallinckrodt Department of Pediatrics, the Department of Neurology and Neurosurgery (Neurology), Washington University School of Medicine; and the Division of Neurology, St. Louis Children's Hospital, 500 South Kingshighway, St. Louis, Missouri.

A 10-year-old girl developed bilateral blindness and partial third nerve paresis immediately following a closed head injury. Bilateral optic atrophy developed subsequently. This is the first report of an association between second and third nerve injuries after minor head trauma in the absence of a preexisting lesion. The pathophysiology of indirect injury to the optic nerve under these circumstances in uncertain, but the lesions in this patient seemed to be due to ischemia.

Reprint requests should be addressed to Dr. H. Phillip Venable, 407 Oak St., RD, Ballwin, Missouri 63011.

This work was supported in part by the Allen P. and Josephine B. Green Foundation, Mexico, Missouri.

Accepted for publication October 28, 1977.