A contusion involving his occipital lobes or another part of the post-chiasmal visual pathway leading to a delayed onset degenerative and diffuse axonal injury of the brain. This result is completely consistent with a coup/contra coup/contusional brain trauma from a severe motor vehicle accident, with that causing a severe disturbance in vision that would not manifest itself as a definite scotoma on visual field plotting. Although this could be further assessed by an MRI scan of the brain or a PET/CT scan of the brain to evaluate post-chiasmal (optic tract, thalamic, optic radiation and occipital lobe) structure and function, the absence of positive findings would not rule out this pathology due to the resolution limits of the MRI and PET/CT modalities.
Occipital lobe medical expert witness specialties include ophthalmology, neuro ophthalmology neuroradiology, neurology, and neuropsychology.