OBJECTIVETo establish the animal model of traumatic optic neuropathy similar to clinical feature by injuring the optic nerve of the pipeline through the ethmoid and sphenoid sinus. The electrophysiology and morphology were observed.

METHODSThe optic nerve in 2 cats was anatomically observed. Thirty healthy adult cats were divided into 1 h, 1 d, 3 d, 1 w, 2 w, 4 w injury groups. The right eye was selected as the experiment eye, and the left as the control. The optic canals were damaged by the injury instrument. The changes of optic nerve were observed using light and electron microscope. The pattern reversal visual evoked potential (PR-VEP) was used to determine the succeed model and pupil was monitored. PR-VEP and neural tissue morphology were examined at intervals of 1 h, 1 d, 3 d, 1 w, 2 w, 4 w after trauma.

RESULTSEight cats had Marcus-Gunn's pupil, and 22 cats did not have after injury. Neural tissue was physaliphorous degeneration in light microscope. The neural fibers swelled gradually and fibers physaliphorous degeneration in the first day after damage. At the seventh day, the bubble enlarged to be a big flat. After two weeks, the big flat bubble came out to be a bigger bubble. Under the electronic microscope, axons were physaliphorous degeneration, crack emerged between axon membrane and myelin sheath and myelin sheath were loose in the first day. At the third day, axon swelled, physaliphorous degeneration rose and myelin sheath were loose obviously. At the seventh day, axon and myelin sheath appeared loop in half cycle and bubble-like broke up. A lot of pieces came out and axon became physaliphorous and uniform. Microtubule and microfilament disappeared. After two weeks, myelin sheath became onion-like. On fourth week, myelin sheaths enlarged and squeezed to center. Axoplasm disappeared and neural tissues collapsed.

CONCLUSIONSThis animal model was similar to clinical optic nerve decompression through ethmoid and sphenoid sinus. The change of PR-VEP and neuromorphology were distinct before and after trauma. The pathological changes of optic nerve catching vibrated injury are mainly degeneration, so earlier decompression of optic nerve may improve the visual function.

Animals ; Cats ; Disease Models, Animal ; Evoked Potentials, Visual ; Optic Nerve ; pathology ; physiopathology ; Optic Nerve Injuries ; pathology ; physiopathology

BACKGROUNDTraumatic optic neuropathy (TON) is one of the reasons for permanent vision loss. Currently, the clinical practices may not be sufficient for direct assessments and comprehensively determining the location and extent of the patients with optic nerve injury in traumatic optic neuropathy. Magnetic resonance imaging (MRI) provides a non-invasive option. However, rare reports have found whether the differentdegree of injury of the optic nerve can be detected by manganese-enhanced MRI (MEMRI). This study aimed to explore the efficacy of MEMRI in the visual pathway for different severity of opitic nerve injury in rats.

METHODSThe different injuries of mild, moderate, and heavy damages were created by modified reverse tweezer and were evaluated by counting retinal ganglion cells (RGCs) and VEP ananlysis. Sprague-Dawley (SD) rats were intravitreally injected with 2 l of 25 mmol/L MnCl2, which has been confirmed as a safe injection concentration. The contrast-to-noise ratio (CNR) of MEMRI for optic nerve enhancement at different injury levels was measured.

RESULTSThe location of the significantly decreased signal point on optic nerve (ON) was corresponding to the location we made. However, similar findings are not obvious, or even have not been observed in 28 days in each group and also in 14 days at F100 group, indicating that MEMRI could be directly intuitive positioned in the early stage on the optic nerve injury.

CONCLUSIONSThe possibility of using MEMRI in optic nerve injury in a safe injection concentration of 25 mmol/L is confirmed. Therefore, it is possible to detect the severity of the optic nerve by MEMRI examination.

Animals ; Magnetic Resonance Imaging ; methods ; Male ; Manganese ; Optic Nerve Injuries ; diagnosis ; pathology ; Rats ; Rats, Sprague-Dawley ; Retinal Ganglion Cells ; pathology

OBJECTIVE: To observe the change of retinal ganglion cells (RGCs)and the expression of Bad after optic nerve injury, so as to study the changes of optic function level on morphology and molecular. METHODS: The experimental models of optic nerve crush were established in fifty Wistar rats. At the different time after injuries (from one to twenty-eight day), the changes of RGCs were observed under microscope. Immunohistochemiscal technique and computer image analysis methods were performed to observe the changes of Bad in RGCs in rats. RESULTS: The number of RGCs was reduced significantly according to partial lesion of optic nerve crush. An initial loss of RGCs densities was accelerated in one week after nerve crush, two weeks later the trend mitigated. After four weeks, no obvious change were observed. The expression of Bad increased in 3 days, reached peak in 5 days, and declined one week later. No obvious changes were observed after two weeks. CONCLUSION The expression of Bad lead to the loss of RGCs following optic nerve crush. This is the important reason of loss optic function. The identification on optic nerve injuries should be done at least four weeks later.
Animals ; Cell Death ; Disease Models, Animal ; Female ; Forensic Medicine ; Male ; Nerve Crush ; Optic Nerve/physiopathology* ; Optic Nerve Injuries/pathology* ; Random Allocation ; Rats ; Rats, Wistar ; Retinal Ganglion Cells/pathology* ; Time Factors ; bcl-Associated Death Protein/metabolism*

OBJECTIVETo investigate the effect of moderate hypothermia on responses of axonal cytoskeleton to axonal injury in the acute stage of injury.

METHODSOf fifteen adult guinea pigs, twelve animals were subjected to stretch injury to the right optic nerves and divided into the normothermic group (n = 6) in which the animal's core temperature was maintained at 36.0-37.5 degrees C and the hypothermia group (n = 6) in which the core temperature was reduced to 32.0-32.5 degrees C after stretch injury. Remaining three animals sustained no injury to the right optic nerves and served as control group. Half of injured animals (n = 3) of either normothermic group or hypothermic group were killed at either 2 hours or 4 hours after injury. The ultrastructural changes of axonal cytoskeleton of the right optic nerve fibers from the animals were examined under a transmission electron microscope and analyzed by quantitative analysis with a computer image analysis system.

RESULTSAt 2 hours after stretch injury, there was a significant reduction in the mean number of microtubules (P < 0.001), and a significant increase in the mean intermicrotubule spacing (P < 0.05 or P < 0.01) in axons of all sizes in normothermic animals. The mean number of neurofilaments also decreased statistically (P < 0.01) in large and medium subgroups of axons in the same experimental group at 2 hours. By 4 hours, the large subgroup of axons in normothermic animals still demonstrated a significant decline in the mean number of microtubules (P < 0.01) and an increase in the mean intermicrotubule spacing (P < 0.05), while the medium and small subgroups of axons displayed a significant increase in the mean number of neurofilaments (P < 0.05) and reduction in the mean interneurofilament spacing (P < 0.05). On the contrary, either the mean number of microtubules and the mean intermicrotubule spacing, or the mean number of neurofilaments and interneurofilament spacing in axons of all sizes in hypothermic stretch-injured animals was not significant different from the mean values of sham-operated animals.

CONCLUSIONSPosttraumatic moderate hypothermia induced immediately after axonal injury results in substantial protection of axonal cytoskeleton and ameliorates axonal damage.

Animals ; Axons ; pathology ; ultrastructure ; Culture Techniques ; Diffuse Axonal Injury ; pathology ; prevention & control ; therapy ; Disease Models, Animal ; Guinea Pigs ; Hypothermia, Induced ; methods ; Male ; Microscopy, Electron ; Optic Nerve ; pathology ; ultrastructure ; Optic Nerve Injuries ; prevention & control ; therapy ; Probability ; Random Allocation ; Reference Values

OBJECTIVES: To investigate the characteristics and objective assessment method of visual field defects caused by optic chiasm and its posterior visual pathway injury. METHODS: Typical cases of visual field defects caused by injuries to the optic chiasm, optic tracts, optic radiations, and visual cortex were selected. Visual field examinations, visual evoked potential (VEP) and multifocal visual evolved potential (mfVEP) measurements, craniocerebral CT/MRI, and retinal optical coherence tomography (OCT) were performed, respectively, and the aforementioned visual electrophysiological and neuroimaging indicators were analyzed comprehensively. RESULTS: The electrophysiological manifestations of visual field defects caused by optic chiasm injuries were bitemporal hemianopsia mfVEP abnormalities. The visual field defects caused by optic tract, optic radiation, and visual cortex injuries were all manifested homonymous hemianopsia mfVEP abnormalities contralateral to the lesion. Mild relative afferent pupil disorder (RAPD) and characteristic optic nerve atrophy were observed in hemianopsia patients with optic tract injuries, but not in patients with optic radiation or visual cortex injuries. Neuroimaging could provide morphological evidence of damages to the optic chiasm and its posterior visual pathway. CONCLUSIONS Visual field defects caused by optic chiasm, optic tract, optic radiation, and visual cortex injuries have their respective characteristics. The combined application of mfVEP and static visual field measurements, in combination with neuroimaging, can maximize the assessment of the location and degree of visual pathway damage, providing an effective scheme for the identification of such injuries.
Humans ; Optic Chiasm/pathology* ; Visual Pathways/pathology* ; Visual Fields ; Evoked Potentials, Visual ; Random Amplified Polymorphic DNA Technique ; Hemianopsia/complications* ; Vision Disorders/pathology* ; Optic Nerve Injuries/diagnostic imaging* ; Brain Injuries, Traumatic/diagnostic imaging*

OBJECTIVE: To study the injury modes, the injury characteristics, the disability grade assessments and other relative problems in eye injuries after traffic accidents. METHODS: Eighty four ocular disability cases after traffic accidents collected from March 2007 to March 2009 in our institute were retrospectively analyzed. Then to study the ocular disability reasons, the assessment time and methods. RESULTS: The main cause of ocular disability is visual dysfunction, and the other causes for example eyeball missing, injury of eyelid, injury of lacrimal apparatus, traumatic cataract and defect of visual field were rare relatively. Most ocular injuries happened to single eye. The disability grades were often from VII to X. CONCLUSION The accuracy of visual function expertise could be improved by using some tests and visual electrophysiological measurements. The vision and ophthalmology data before the injury of the wounded who has intrinsical disease should be provided. The assessment time should be delayed for people whose visual function still may change.
Accidents, Traffic ; Adult ; Age Distribution ; Disability Evaluation ; Eye Injuries/pathology* ; Eyelids/injuries* ; Female ; Forensic Pathology ; Humans ; Injury Severity Score ; Male ; Middle Aged ; Optic Nerve Injuries/pathology* ; Retrospective Studies ; Sex Distribution ; Time Factors ; Visual Acuity ; Young Adult

Adolescent ; Adult ; Angiography, Digital Subtraction ; Child ; Decompression, Surgical ; methods ; Female ; Humans ; Magnetic Resonance Angiography ; Male ; Middle Aged ; Optic Nerve Injuries ; diagnostic imaging ; pathology ; Young Adult

PURPOSE: To evaluate optic disc pallor using ImageJ in traumatic optic neuropathy (TON). METHODS: This study examined unilateral TON patients. The optic disc was divided into 4 quadrants (temporal, superior, nasal, and inferior), consistent with the quadrants on optical coherence tomography (OCT) retinal nerve fiber layer (RNFL) thickness maps. Optic disc photography was performed and disc pallor was quantified using gray scale photographic images imported into ImageJ software. The correlation between optic disc pallor and RNFL thickness was examined in each quadrant. RESULTS: A total of 35 patients (31 male, 4 female) were enrolled in the study. The mean participant age was 34.8 +/- 15.0 years (range, 5 to 63 years). Overall RNFL thickness decreased in 6 patients, with thinning most often occurring in the inferior quadrant (28 of 35 eyes). There was a significant correlation between optic disc pallor and RNFL thickness (superior, rho = -0.358, p = 0.04; inferior, rho = -0.345, p = 0.04; nasal, rho = -0.417, p = 0.01; temporal, rho = -0.390, p = 0.02). The highest level of correspondence between disc pallor and RNFL thickness values outside of the normative 95th percentiles was 39.3% and occurred in the inferior quadrant. CONCLUSIONS: Optic disc pallor in TON was quantified with ImageJ and was significantly correlated with RNFL thickness abnormalities. Thus, ImageJ evaluations of disc pallor may be useful for evaluating RNFL thinning, as verified by OCT RNFL analyses.
Adolescent ; Adult ; Child ; Child, Preschool ; Colorimetry/methods/standards ; Diagnosis, Computer-Assisted/*methods/standards ; Female ; Humans ; Male ; Middle Aged ; Optic Atrophy/etiology/*pathology ; Optic Nerve Diseases/etiology/*pathology ; Optic Nerve Injuries/*pathology ; Photography/*methods/standards ; Reproducibility of Results ; Software ; Tomography, Optical Coherence/*methods/standards ; Trauma Severity Indices ; Young Adult

The authors analysed 147 cases of basal skull fracture which were treated in the Department of Neurosurgery, Chungnam National University Hospital from January 1989 to December 1992. These fractures are difficult to diagnose by ordinary X-ray examination and are frequently inferred by clinical signs. The clinical features and radiological findings were reviewed. The results of the analysis are summarized as follows : 1) The basal skull fractures were more common in men than women-the ratio being 6 : 1. 2) In decreasing order of cause of basal skull fractures were traffic accidents(77%), fall down, assault and slipping. 3) The minor head injury, Glasgow Coma Scale Score(GCS) of 13 to 15, was 79 cases(54%), the moderate head injury 40 cases(27%) and the severe head injury 18 cases(19%). 4) In decreasing order of clinical features were otorrhea(71%) rhinorrhea(48%) and raccoon eye(33%) etc. 5) In decreasing order of the combined pathologies were skull fracture(55%), subdural hematoma(17%), epidural hematoma(16%) and intracerebral hematoma(12%) etc. 6) The facial nerve, vestibulo-cochlear nerve and optic nerve were the most commonly injured cranial nerve. 7) CSF leakage was noted in 139 cases and among them immediate type was far more common(96%) than the delayed type. 8) The incidence of meningitis was 5.4% and most of them associated with CSF leakage and the prophylatic antibiotic treatment has no effect to decrease infection rate. 9) In decreasing order of the frequency associated injuries were facial bone fracture(47%), clavicle fracture(19%), lower extremities fracture(9%) and upper extremities fracture(7%) etc.
Chungcheongnam-do ; Clavicle ; Cranial Nerve Injuries ; Cranial Nerves ; Craniocerebral Trauma ; Facial Bones ; Facial Nerve ; Glasgow Coma Scale ; Humans ; Incidence ; Lower Extremity ; Male ; Meningitis ; Neurosurgery ; Optic Nerve ; Pathology ; Raccoons ; Skull Fractures* ; Skull* ; Upper Extremity