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Using computed tomographic scans and reformatted images of the optic canal region, we were able to define osseous abnormalities in nine patients with sudden traumatic blindness resulting from indirect trauma to the optic nerve. Six patients had optic canal fractures, two had fractures of adjacent structures, and one patient did not have a fracture. Patients received corticosteroid therapy, surgical decompression of the optic canal, both types of treatment, or no specific treatment for the nerve injury. Although there was no correlation between the abnormality identified by computed tomography and treatment results, our findings provided further evidence that a canal fracture is not necessary for injury of the optic nerve to occur. We recommend that patients with sudden visual loss after blunt head trauma undergo a computed tomographic scan of the optic canal region.
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