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Letter
Anterior pathway vision loss due to subdural haematoma
  1. D A Hollander,
  2. J M Stewart
  1. Department of Ophthalmology, University of California, San Francisco, CA, USA
  1. Correspondence to: Jay M. Stewart MD, University of California, San Francisco, Department of Ophthalmology, 10 Koret Way, Suite K-301, San Francisco, CA 94143, USA; ne62yahoo.com

https://doi.org/10.1136/bjo.87.11.1423

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    Patients with vision loss associated with subdural haematomas typically present with homonymous hemianopias secondary to compression of the posterior cerebral artery during transtentorial herniation.1,2 In these cases, necropsy studies have demonstrated pregeniculate involvement in addition to occipital lobe lesions.2 We present a case illustrating a rarely reported phenomenon of anterior pathway vision loss associated with a subdural haematoma without any evidence of optic disc swelling, occipital lobe disease, or radiographic signs of chiasmal or optic nerve compression.

    Case report

    A 51 year old man, who had previously undergone two craniotomies (October 1992 and November 2000) for resection of an epidermoid tumour at the cerebellopontine angle, developed hydrocephalus and had a ventriculoperitoneal shunt placed in January 2001. Eleven months following placement of the shunt, the patient presented with ataxia and headaches but no visual complaints. A computed tomograph (CT) scan showed a right subdural haematoma measuring 2.8 cm on coronal section, and 150 ml of blood were drained via a burr hole.

    One month following the drainage procedure, the patient presented to the hospital with a …

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