PMC10408612_01
Computed tomography (CT) scan and magnetic resonance imaging (MRI) pre- and postoperatively. Thin-slice CT showing no optic canal fracture (a); MRI showing no intracranial traumatic lesions (b and c).
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F1
There were no fractures or traumatic lesions on the head thin-slice computed tomography and magnetic resonance imaging [Figures 1a-c].
Visual-evoked potential at admission. The mid-occipital electrode (Mo) is placed above the external occipital protuberance (inion). Lateral occipital electrodes (Lo and Ro) are placed 4 cm to the left and right to the Mo.
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F2
The amplitude of the flash VEP with right-sided stimulation was not zero; however, it was approximately 45% lower than that with left-sided stimulation [Figure 2].
Pre- and post-operation three-dementional images of optic canal decompression (a and b). White arrow indicates the decompressed optic canal.
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F3
Therefore, 7 h after the injury, we performed right OCD through frontotemporal craniotomy [Figures 3a and b] with intraoperative flash VEP. There was a bone fracture at the optic canal roof but no injury to the optic nerve.
Changes of visual-evoked potential during operation and follow-up time. After craniotomy and drilling out of the optic canal, the amplitude increased at all electrodes in the right-sided stimulation. The final measurement improved from 2.1 muV to 6.1 muV at L0 (Left occipital electrode), from 4.5 muV to 9.5 muV at M0 (Middle occipital electrode), and from 4.3 muV to 10.4 muV at R0 (Right occipital electrode).
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VEP from 2.1 muV to 6.1 muV at L0, from 4.5 muV to 9.5 muV at M0, and from 4.3 muV to 10.4 muV at R0. VEP with right-sided stimulation has finally improved to 80% of contralateral VEP after drilling [Figure 4].
Change in the visual field of the right eye by Goldmann visual field meter. (a) Pre-operatively. (b) Post-operatively. (c) Thirty days after the operation, vision was restored in all directions, except for the central field of view.
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F5
On postoperative day 30, his right eyesight was 0.2 and he could see all directions except for the central field of view, as shown in Figure 5.