Our law firm has experience representing people who have sustained temporary complete blindness (or sometimes called “Fleeting Blindness” or what doctors may call Amaurosis Fugax) following an injury to the brainstem or upper cervical spine in a motor vehicle collision. Needless to say, it is a cause of great concern for people who lose sight temporarily after a traumatic injury. While some of the clients have had multiple episodes of complete blindness lasting only 5-10 minutes, one client reported a 30 minute total loss of vision, and another client reported a 45 minute total loss of vision after a series of episodes of blindness lasting approximately 10 minutes. While the insurers and defense doctors will claim this is purely psychological (often “conversion disorder”), we are aware of the actual physical injury causing this injury and are able to prove that at trial for people who have sustained blindness after trauma.
There are a number of emergency situations directly following a trauma to the head and/or neck including things like an artery dissection or an bleeding traumatic brain injury which should be checked out at an Emergency Room immediately. But this discussion considers people who have these symptoms sometimes months after the injury, or on a repeated basis.
These clients have one thing in common. They each sustain injuries to the ligaments of the upper neck, referred to as the Alar Ligaments, the Transverse Ligament and/or the Capsular ligaments at the Occiput (posterior skull) - C1- C2 region (often referred to as the Craniocervical Junction, or the Atlantoaxial region.) The end result of damage to these structures (which support the skull on the neck) is that they leave the C1 vertebra unstable. Instability of the C1 vertebra leaves the person particularly susceptible to a variety of symptoms given the compact and critical anatomy in that area of the body - namely the vertebral artery, the Foramen Magnum, and the transition of the brain stem / spinal cord.
The full extent of symptoms arising from injuries to this area are beyond the scope of this article, but can include a feeling that the head feels unstable on the neck (or what some people refer to as "bobble head," dizziness with neck motion, and abnormal (and repeatable) clunking sound with movement of the head, other visual defects besides blindness (often tunnel vision or a “greying” out of vision), low grade headaches, and other symptoms. [Injuries to this area also can cause a traumatic or Type II Chiari, causing abnormal pressure in the brain leading to different symptoms which are similarly difficult to diagnose.]
The temporary blindness and other temporary visual symptoms occurs due to an instability of the C1 vertebra leading to compression of the vertebral artery within the transverse foramen of the neck. The vertebral artery gets stressed and then compressed as C1 moves an abnormal amount, thereby shutting down blood flow from the vertebral artery into the brain. This in turn shuts down the blood supply to the occipital lobe which processes visual information in the brain. This lack of blood flow results in the temporary blindness.
The injuries to the ligaments of the Craniocervical Junction and the resultant C1 instability are the subject of the new medical text The Craniocervical Syndrome and MRI published by Karger (2015). The book features notable doctors studying this condition, including Raymond Damanian, inventor of the MRI machine. At p.58 of the text, it notes “Misalignments of the CCJ [Craniocervical Junction] have been shown to contribute to vertebral artery insufficiency. Vertebrobasilar insufficiency or vertebral basilar ischemia refers to temporary symptoms due to decreased blood flow in the posterior circulation of the brain.” This includes the most posterior area of the brain, the occipital lobe, which controls the processing of visual information. Lack of blood to this area, results in temporary blindness.
Needless to say, this is a serious injury that should carry a substantial value in a personal injury claim. The only known method of correcting this instability is a fixation surgery of C1, a surgery which few neurosurgeons are willing to perform without a fracture of one of the cervical vertebra. Which leaves people with these injuries the task of either finding a doctor willing to do the surgery or living with the symptoms for life.
Our firm has extensive history handling claims of C1 instability after trauma. Dr. DeShaw has lectured both nationally and internationally to both doctors and lawyers on this topic.
If you have a case of temporary blindness after a traumatic brain or cervical spine injury, feel free to call our office for a free initial consultation at (503) 227-1233.
[Please note: This type of post-traumatic temporary blindness is different than a temporary loss of vision (usually in one eye rather than both) caused by a loss of blood in the eye itself caused by stroke. You should seek emergency medical services immediately regardless of whether the vision loss is only one sided or on both sides of your vision.]