Visual evoked potential evaluation following brain injury in school-aged children.

Aim: The research aimed to establish reference values of visual evoked potentials among school-aged children after brain injury. Methods: Eighteen patients with persisting visual symptoms after brain injury have been examined. A pattern-VEP test has been used during the examination. Results: The prolongation of the N2 wave in 55,6%-66,6%, P wave in 55,7%-66,7%, and N3 wave in 16,7%-22,2% was determined in the research group. Likewise, the decrease in the amplitude of the P wave was determined in the case of 16,7%-33,3%. According to the topography, we concluded that the prechiasmatic alteration was predominantly determined as bilateral in the optic pathways, with emphasis equally on the right and left. Conclusions: VEP evaluation remains one of the most credible methods of examination. In the case of moderate or severe traumatic optic neuropathy, it allows the detection of damage to the optic pathways before the appearance of organic changes that are often irreversible. The possibility of early detection of such modifications could justify the initiation of a dosed stimulatory treatment, to avoid damage to the optic pathways that would induce secondary optic atrophy. Abbreviations: VEP = visual evoked potentials, MRI = magnetic resonance imaging.

Contrast sensitivity and aspects of binocular vision alteration in school-aged children after head injury.

Aim: The research aimed to establish whether contrast sensitivity is a reliable method of evaluation in the case of school-aged children after head injury, and also to establish aspects of binocular vision alteration in the acute phase of TBI. Materials and methods: Forty-eight individuals with persisting visual symptoms after brain injury have been examined. Results: The rate of contrast sensitivity was determined to be 61%-100% in the research group in 56,3%-58,3% cases, compared to the control group, in which the prevalence was 93,7%-95,8% cases. Repeated evaluation during 4 months after the head trauma revealed an incidence of 83,3%-89,6% for the research group and 97,9% for the control group in the same 61%-100% interval. Binocular vision proved to be unchanged in 79,17% of patients, being determined as absent only in 4,16% of patients who later presented a secondary divergent strabismus. Conclusions: Contrast sensitivity is an easily performed method for the group of school-aged children after head injury. Although it is often considered by children an interesting game, its results should be taken into consideration while suspecting a traumatic optic neuropathy. Since most of the pediatric patients aged between 7-18 years, show a slight decrease of contrast sensitivity ability after head trauma, this examination should be performed as a part of ophthalmological evaluation in pediatric patients following head injury.