Visual disturbances diagnose in children after head trauma

Abstract

Introduction. Even if medicine science undergoes a continous development we may still outline that brain injury still be considered as one the most frequent medical condition all around the world. As far as the statistic outline that the rate of brain trauma among children is all the time in progress rating double as speaking about age between 7 and 18 years, still we find difficult evaluating this category of patients. That is why visual disturbances that may outcome of a brain trauma in a child will hace a define role in its future development as an adult. The managment comes quite different when we speak of children versus adults, requesting an adequate approach for visual post traumatic deficiencies apreciation. Aim of the study. Aim of the study is to determine and classify visual disturbances that appear after head trauma in children in order to assess a personalized approach. Materials and methods. The study was a case control research based on 49 patients hospitalized at the neurosurgery department suffering from a traumatic brain injury (TBI) and 49 patients with visual disturbances but with no brain injury in the past five years. The patients have undergone a full ophthalmological evaluation by using all of the standart and auxillary investigations required. Since the research has been provided for children, the diagnose approach has been selected individually since the patients were hospitalized at different age and general status. Results. Results showed a loss of visual acuity in the first 72 hours after trauma number being determined in 41 (83,7 %) patients after TBI, mostlly diagnosed with hyperopia indexes while undergoing autorefractometric evaluation in 45 (91,8%) patients. There have been also determined changes in visual field examination in the acute stage after trauma, patients presenting fixation loss in almost 44 (89.8%) patients establishing visual field disturbances of a differen area in almost all of this patients. Recording to the contrast sensitivity test we may also outline a clear disturbance for color perception being present in 46 patients after TBI that in 94% cases. We may also outline that 45 children presented convergence insufficiency with an average near-point of convergence (NPC) ranged between 7-9 mm. Conclusions. The research noted once again that children present a full spectrum of vision alteration being a process established fast but with clear pecularities for a full recovery. Due to some distinguished aspects in cerebral blood flow regulation, the pediatric age group is subject to the development of intracranial hypertension (ICH), the cause of the development of which is the expansion of the brain. This reveals the cause for the acute onset of visual disturbances after head injury in children. Also it has been revealed that most of the standart ophthalmologic investigations should be indicated not in the acute stage since the values may be increased due to a transient picture of visual disturbances without a need in treatment but only with concern of future evaluation.