scholarly journals A Case of Terson's Syndrome Caused by Severe Aneurysmal Subarachnoidal Hemorrhage with Vitreous Surgery for Organized Vitreous Hemorrhage

2018 ◽  
Vol 46 (5) ◽  
pp. 384-388
Author(s):  
Ryota MASHIKO ◽  
Yoshimi SUGIURA ◽  
Ryo KUMAGAI ◽  
Yasushi SHIBATA
Keyword(s):  
Vitreous Hemorrhage ◽  
Vitreous Surgery ◽  
Subarachnoidal Hemorrhage ◽  
Terson’S Syndrome ◽  
Terson's Syndrome

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

1992 ◽  
Vol 76 (5) ◽  
pp. 766-771 ◽  
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.

Magnetic resonance imaging findings of Terson’s syndrome suggesting a possible vitreous hemorrhage mechanism

2010 ◽  
Vol 54 (2) ◽  
pp. 135-139 ◽  
Author(s):  
Masashi Sakamoto ◽  
Kimitoshi Nakamura ◽  
Maho Shibata ◽  
Kunio Yokoyama ◽  
Mitsuru Matsuki ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Vitreous Hemorrhage ◽  
Imaging Findings ◽  
Resonance Imaging ◽  
Terson’S Syndrome ◽  
Terson's Syndrome

scholarly journals Terson's syndrome

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

Pars Plana Vitrectomy for Terson's Syndrome—Visual Outcome and Impact on Postintracranial Hemorrhage Rehabilitation

1999 ◽  
Vol 13 (4) ◽  
pp. 255-257 ◽  
Author(s):  
Bogna Zborowska ◽  
Alexander Poon ◽  
Con Retsas
Keyword(s):  
Visual Acuity ◽  
Barthel Index ◽  
Vitreous Hemorrhage ◽  
Visual Outcome ◽  
Snellen Chart ◽  
Barthel Score ◽  
Terson’S Syndrome ◽  
Pars Plana ◽  
Terson's Syndrome

We report the visual outcomes and change in the Modified Barthel Index Score (BIS) in four patients with Terson's syndrome treated with vitrectomy. A retrospective study of four patients with Terson's syndrome from Royal Prince Alfred Hospital, Sydney, was carried out. Assessment of visual acuity and physical disability pre- and post-vit rectomy using the Snellen Chart and the Barthel Index, respectively, was performed. All four patients were found to have improved visual acuity and BIS post vitrectomy. Improved vision from treatment of vitreous hemorrhage decreases the disability after intracranial hemorrhage and Terson's syndrome. Early diagnosis and management would shorten the rehabilitation process and improve the quality of life. Ophthalmo logic management depends on the severity of vitreous hemorrhage, whether it is uni lateral or bilateral, and its impact on patient's daily function. Key Words: Terson's syn drome—Subarachnoid hemorrhage—Vitreous hemorrhage—Vitrectomy—Visual acuity—Modified Barthel Score Index.

Comparison of CT and clinical findings of Terson's syndrome in 121 patients: a 1-year prospective study

2014 ◽  
Vol 120 (5) ◽  
pp. 1172-1178 ◽  
Author(s):  
Elina Koskela ◽  
Johanna Pekkola ◽  
Riku Kivisaari ◽  
Tero Kivelä ◽  
Juha Hernesniemi ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Prospective Study ◽  
Vitreous Hemorrhage ◽  
World Federation ◽  
Female Sex ◽  
Specificity And Sensitivity ◽  
Ruptured Intracranial Aneurysm ◽  
Ct Head ◽  
Terson’S Syndrome ◽  
Terson's Syndrome

Object Terson's syndrome (TS) is a vitreous hemorrhage in association with subarachnoid hemorrhage (SAH). Its diagnosis is often delayed, which may result in vision loss secondary to treatable conditions. Methods to hasten early diagnosis and consequent ophthalmic referral are desirable. The aims of this study were 1) to assess the specificity and sensitivity of conventional head CT for diagnosing TS in patients with aneurysmal SAH (aSAH); and 2) to determine the incidence of TS and its association with age, sex, aSAH severity, and overall mortality. Methods Patients admitted to Helsinki University Central Hospital who underwent surgery or endovascular treatment for a ruptured intracranial aneurysm during 2011 were participants in this prospective study. They underwent serial dilated fundoscopic examinations during a 6-month period. Two radiologists independently reviewed ocular findings suggestive of TS on conventional CT head scans obtained in all patients as a routine diagnostic procedure. Associations between TS and relevant clinical, radiological, and demographic data were analyzed with uni- and multivariate logistic regression. Results Of 121 participants, 13 (11%) presented with TS, and another 22 (18%) with intraretinal hemorrhages. For reviewing CT head scans, the overall observed agreement between the 2 raters was 96% (116 of 121 cases), with a substantial κ of 0.69 (95% CI 0.56–0.82). The sensitivity of the CT findings for TS was 42%, and the specificity was 97%. Associations of the World Federation of Neurosurgical Societies (WFNS) and Hunt and Hess grades on admission, the presence of intracerebral hemorrhage, female sex, and aneurysm length with TS were all statistically significant. Logistic regression demonstrated that sex and WFNS grade were independently associated with TS and provided the best fit to the data. Conclusions Routinely looking for TS findings in CT head scans may prove valuable in clinical practice. Terson's syndrome is associated with female sex and poor clinical condition on admission.

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

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.

scholarly journals Terson's syndrome: neurosurgical considerations on the subject of a rare case with ophthalmological sequelae

2013 ◽  
Vol 32 (02) ◽  
pp. 114-117
Author(s):  
Bruno Lourenço Costa ◽  
Filipe Mira Ferreira ◽  
Augusto Barbosa ◽  
José Lozano Lopes ◽  
Armando Lopes
Keyword(s):  
Surgical Treatment ◽  
Visual Loss ◽  
Aneurysmal Subarachnoid Hemorrhage ◽  
Vitreous Hemorrhage ◽  
Severe Visual Loss ◽  
Timely Review ◽  
History Of ◽  
Terson’S Syndrome ◽  
Terson's Syndrome ◽  
The Right

AbstractAccording to prospective studies, vitreous hemorrhage may be diagnosed in 8%-27% of the patients with aneurysmal subarachnoid hemorrhage (SAH) (Terson's syndrome) and has been associated with a bad neurological outcome. In spite of its incidence and prognostic value, vitreous hemorrhage is underdiagnosed. We describe the case of a 48 year-old woman who was diagnosed with a SAH due to the rupture of an aneurysm of the right middle cerebral artery bifurcation that was surgically treated with minimal neurological morbidity. However, due to vitreous hemorrhage in the right eye, the patient developed visual loss that did not recovered after proper surgical treatment. In the context of the present case we take a timely review of the literature, discussing the incidence, pathophysiology, treatment and prognosis of Terson's syndrome. The reported case stresses that the natural history of Terson's syndrome is not always synonymous with good outcome. Significant visual sequelae due to vitreous hemorrhage are very rare after proper conservative or surgical treatment. The severe visual loss of this patient emphasizes the need for a systematic, early and serial ophthalmological evaluation of all patients with aneurysmal SAH.

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

1998 ◽  
Vol 56 (1) ◽  
pp. 133-136
Author(s):  
GIULIO CESARE PINNOLA ◽  
SÉRGIO MURILO CORRÊA ◽  
SÔNIA BEATRIZ F. RIBEIRO ◽  
ALFREDO LEBOREIRO-FERNANDEZ ◽  
JAIME OLAVO MARQUEZ
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Early Diagnosis ◽  
Intracranial Hemorrhage ◽  
Vitreous Hemorrhage ◽  
Medical Intervention ◽  
Favorable Outcome ◽  
Favorable Prognosis ◽  
Terson’S Syndrome ◽  
Terson's Syndrome ◽  
Syndrome Report

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 .

scholarly journals Terson's Syndrome Due to Aneurismal Subarachnoid Hemorrhage

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

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

1998 ◽  
Vol 88 (5) ◽  
pp. 851-854 ◽  
Author(s):  
Ralph J. Medele ◽  
Walter Stummer ◽  
Arthur J. Mueller ◽  
Hans-Jakob Steiger ◽  
Hans-Jürgen Reulen
Keyword(s):  
Brain Injury ◽  
Vitreous Hemorrhage ◽  
Raised Intracranial Pressure ◽  
Severe Brain Injury ◽  
Content Type ◽  
Terson’S Syndrome ◽  
Terson's Syndrome ◽  
Acute Event ◽  
Fine Print ◽  
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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