Answer for BIR CoW 17 Nov 2024
Traumatic Optic Neuropathy
Findings
Discussion
There is significant variation in the approach to neuroimaging in traumatic optic neuropathy (TON) worldwide. While some clinicians recommend computed tomography (CT) or magnetic resonance imaging (MRI), or both, for all cases, others limit these investigations to patients with progressive visual deterioration or when therapeutic interventions are under consideration.
Before performing MRI, it is critical to exclude the presence of intraorbital or intraocular metallic foreign bodies using conventional radiography. CT remains the imaging modality of choice for evaluating optic canal fractures and assessing their full extent, especially in preparation for potential surgical intervention.
Findings
- Altered signal intensity observed in the retrobulbar segment of the right optic nerve, with surrounding fat stranding and contusion.
- Partial tear of the right inferior rectus muscle accompanied by a blowout fracture of the right orbital floor.
- Herniation of the torn right inferior rectus muscle and intraorbital fat into the right maxillary sinus through the fractured orbital floor.
Discussion
There is significant variation in the approach to neuroimaging in traumatic optic neuropathy (TON) worldwide. While some clinicians recommend computed tomography (CT) or magnetic resonance imaging (MRI), or both, for all cases, others limit these investigations to patients with progressive visual deterioration or when therapeutic interventions are under consideration.
Before performing MRI, it is critical to exclude the presence of intraorbital or intraocular metallic foreign bodies using conventional radiography. CT remains the imaging modality of choice for evaluating optic canal fractures and assessing their full extent, especially in preparation for potential surgical intervention.
Note:
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
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We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
If you feel you have answered rightly but cannot find your name in the above list, please call 09551942599.
Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!