Transcranial subdural decompression of the optic canal as a treatment option for traumatic optic neuropathy

Abstract

Objective To investigate the effect of decompression of the optic nerve canal by subdural approach on traumatic optic neuropathy (TON) and the predictive value of DTI. Methods A total of 52 cases with optic nerve neuropathy which underwent microsurgical depression via transcranial subdural approach were retrospectively analyzed from January 2008 to December 2017 at the Neurosurgical Department of No. 101 Hospital of PLA. Before operation, CT and DTI scans were administered. Results The patients were followed up for 3 months after operation. Forty-three patients required the sight recovery to some extent after operations. The effective rate was 82.7% (43/52) and the significant effective rate was 26.9% (14/52). The 43 patients who totally lost their sights had the effective rate of 88.2% (34/43) and the significant effective rate of 27.9% (12/43). Five patients underwent DTI examination. 2 patients whose the optic nerve conduction bundles were not complete the sights did not recover after operation. Another 3 patients whose DIT examination showed the optic nerve conduction beam was intact the postoperative sights were effectively restored. Conclusions The decompression of the optic nerve canal by subdural approach seems safe and effective for the patients of TON. The length of duration longer than 72 hours post injury in the TON patients could not exclude the chance of operation. DTI might be the important predictor for the effect of the operation. Key words: Optic nerve injuries; Subdural space subdural; Neurosurgical procedures; Decompression of optic nerve; Treatment outcome