Terson's syndrome: report of a case with favorable outcome

Terson's syndrome is characterized by the presence of a subarachnoid hemorrhage accompanied by retinal and vitreous hemorrhage leading to a not very favorable prognosis. We describe a case with a good outcome, probably because of a early diagnosis and medical intervention. We emphasize the routine optician's check up as very important in the evaluation of a prognosis in the cases of a suspect intracranial hemorrhage .

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Terson's syndrome: a reversible cause of blindness following subarachnoid hemorrhage

Journal of Neurosurgery ◽

10.3171/jns.1992.76.5.0766 ◽

1992 ◽

Vol 76 (5) ◽

pp. 766-771 ◽

Cited By ~ 78

Author(s):

Andrew M. Garfinkle ◽

Irena R. Danys ◽

David A. Nicolle ◽

Austin R. T. Colohan ◽

Steven Brem

Keyword(s):

Subarachnoid Hemorrhage ◽

Vitreous Hemorrhage ◽

Initial Examination ◽

Content Type ◽

Breakthrough Bleeding ◽

Intraocular Hemorrhage ◽

Terson’S Syndrome ◽

Terson's Syndrome ◽

A Prospective Study ◽

Fine Print

✓ Terson's syndrome refers to the occurrence of vitreous hemorrhage with subarachnoid hemorrhage (SAH), usually due to a ruptured cerebral aneurysm. Although it is a well-described entity in the ophthalmological literature, it has been only rarely commented upon in the neurosurgical discussion of SAH. Fundus findings are reported in a prospective study of 22 consecutive patients with a computerized tomography- or lumbar puncture-proven diagnosis of SAH. Six of these patients had intraocular hemorrhage on initial examination. In four patients vitreous hemorrhage was evident on presentation (six of eight eyes). In the subsequent 12 days, vitreous hemorrhage developed in the additional two patients (three of four eyes) due to breakthrough bleeding from the original subhyaloid hemorrhages. The initial amount of intraocular hemorrhage did not correlate with the severity of SAH. Two of the six patients with intraocular hemorrhage died, whereas five of the 16 remaining SAH patients without intraocular hemorrhage died. Of the four survivors with intraocular hemorrhage, three showed gradual but significant improvement in their visual acuity by 6 months. The fourth underwent vitrectomy at 8 months after presentation and had a good visual result. With modern and aggressive medical and microsurgical management, Terson's syndrome should be recognized as an important reversible cause of blindness in patients surviving SAH.

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Terson's syndrome

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v1i1.3678 ◽

1970 ◽

Vol 1 (1) ◽

pp. 77-79

Author(s):

R Sharma ◽

JK Shrestha

Keyword(s):

Subarachnoid Hemorrhage ◽

Visual Impairment ◽

Key Words ◽

Clinical Features ◽

Vitreous Hemorrhage ◽

Altered Sensorium ◽

Terson’S Syndrome ◽

Terson's Syndrome

Terson's syndrome is rarely encountered in ophthalmic practice. The ophthalmologists should be acquainted with the clinical features and methods of diagnosis of this syndrome. Here we report a middleaged lady with altered sensorium, visual impairment and headache who was diagnosed as having Terson's syndrome after fundoscopy and spinal tap. It was managed conservatively. Key words: vitreous hemorrhage; subarachnoid hemorrhage DOI: 10.3126/nepjoph.v1i1.3678 Nep J Oph 2009;1(1):77-79

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Terson's syndrome in subarachnoid hemorrhage and severe brain injury accompanied by acutely raised intracranial pressure

Neurosurgical FOCUS ◽

10.3171/foc.2001.11.4.3 ◽

2001 ◽

Vol 11 (4) ◽

pp. 851-854

Author(s):

Ralph J. Medele ◽

Walter Stummer ◽

Arthur J. Mueller ◽

Hans-Jakob Steiger ◽

Hans-Jürgen Reulen

Keyword(s):

Subarachnoid Hemorrhage ◽

Brain Injury ◽

Intracranial Pressure ◽

Vitreous Hemorrhage ◽

Raised Intracranial Pressure ◽

Severe Brain Injury ◽

Terson’S Syndrome ◽

Terson's Syndrome ◽

Acute Event ◽

Similar Incidence

Object The syndrome of retinal or vitreous hemorrhage in association with subarachnoid hemorrhage (SAH) is known as Terson's syndrome. The authors' purpose was to determine whether intraocular hemorrhage occurs with similar incidence when caused by severe brain injury accompanied by acutely raised intracranial pressure (ICP). Methods Prospective ophthalmological examination was performed in 22 consecutive patients with SAH or severe brain injury and elevated ICP. Thirteen patients were admitted for SAH (World Federation of Neurological Surgeons Grades II–IV) and nine for severe brain injury (Glasgow Coma Scale scores 3–10). Monitoring of ICP was performed at the time of admission via a ventricular catheter. Initial ICP exceeded 20 mm Hg in all patients. Indirect ophthalmoscopy without induced mydriasis was performed within the 1st week after the acute event. Retinal or vitreous hemorrhage was seen in six (46%) of 13 patients with SAH and in four (44%) of nine patients with severe brain injury. Ocular bleeding was found bilaterally in three patients with SAH and in one patient with severe brain injury (18%). Six of the 10 patients with Terson's syndrome died as a result of their acute event. Conclusions The present results indicate that Terson's syndrome may be related to acute elevation of ICP, independent of its causes, and may occur with similar incidence in patients with severe brain injury and those with SAH. Because recognition and treatment of Terson's syndrome may prevent visual impairment and associated secondary damage to the eye, increased awareness of this entity in all patients with acute raised intracranial hypertension is recommended.

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Terson's Syndrome Due to Aneurismal Subarachnoid Hemorrhage

Anwer Khan Modern Medical College Journal ◽

10.3329/akmmcj.v8i2.33674 ◽

2017 ◽

Vol 8 (2) ◽

pp. 153-156

Author(s):

Sanwar Hossain ◽

Titus Leonard Guda ◽

Forhad Chowdhury ◽

Md Somir Hossain

Keyword(s):

Subarachnoid Hemorrhage ◽

Vitreous Hemorrhage ◽

Retinal Hemorrhage ◽

Intracranial Hemorrhages ◽

Medical College ◽

Intraocular Hemorrhage ◽

Terson’S Syndrome ◽

Terson's Syndrome

Vitreous or retinal hemorrhage occurring in association with subarachnoid hemorrhage is known as Terson's syndrome. In Terson's syndrome, intracranial hemorrhages are followed by intraocular hemorrhage, classically in the subhyaloid space, but may also include subretinal, retinal, preretinal, and vitreal collections. Usually occurs in adult, but can be at any age. It may be unilateral or bilateral. Vitreous hemorrhage recovery is usually spontaneous within 6 to 12 months, otherwise vitrectomy is considered. We report a case of Terson's syndrome which was admitted in Anwer Khan Modern Medical College & Hospital as unilateral Terson's syndrome with multiple intra retinal hemorrhage of left eye associated with Hypertension & Diabetes Mellitus.Anwer Khan Modern Medical College Journal Vol. 8, No. 2: Jul 2017, P 153-156

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