Simple optic atrophy in chronic subdural hematoma

Elke Müller, Hartmut Wenkel

Department of Ophthalmology, University Erlangen-Nürnberg

Chairman: Prof. Dr. G.O.H. Naumann

 

Patient A 68-year old male patient was referred to the University Eye Hospital in Erlangen for evaluation of a conspicious optic nerve head treated externally with antiglaucomatous medication. The patient reported an accident three months ago without head injury and had no ocular complaints. Visual acuity measured 20/30 on the right eye and 10/20 on the left eye. Ophthalmoscopy revealed a pale optic nerve head especially in the upper temporal quadrant of the left eye (Figure 1A/B). A computerized tomography showed a chronic subdural hematoma in the front-parietal region with greater extension on the right side and compression of the right ventricle (Figure 2A/B). The patient was immediately referred to the neurosurgery department for trepanation and removal of the hematoma.

Conclusion A routine ophthalmological examination of asymptomatic patients should include a detailed evaluation of the optic nerve head to rule out glaucomatous or simple optic atrophy.

Key words Simple optic atrophy - chronic subdural hematoma

 
Fig. 1a
Fig. 1b

Figure

1A/B: Optic nerve heads of a 68-year old male with chronic subdural hematoma.

Pale upper temporal quadrant of the left optic nerve head.

2A/B: Computerized tomography of the cranium with chronic subdural hematoma in the front-parietal region with greater extension on the right side and compression of the right ventricle.

 
Fig. 2a Fig. 2b