Ophthalmologic aspects of diagnosis and localization of subdural hematoma

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Abstract
The incidence and localizing value of ocular signs in a series of 389 cases of proven subdural hematoma are presented, and the pertinent literature is reviewed. When present, the various unilateral ocular signs of pupillary dilation, abducens nerve palsy, and homonymous hemianopsia assisted in lateralizing the hematoma in over 90% of the patients. The mechanism of tentorial herniation producing these signs as well as causing misleading ipsilateral pyramidal tract signs is discussed. The necessity of careful and repeated examinations for the presence of such signs is emphasized.