First Author: A.Pastor Vivas SPAIN
Co Author(s): F. Garcia Franco Zuniga
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Terson's syndrome is intraocular haemorrhage (IOH) subsequent to subarachnoid haemorrhage (SAH). Its presence is associated with higher mortality in SAH.
We report a case of Terson's syndrome
A 25-year-old Caucasian gentleman collapsed and became comatose after a head trauma. CT head scans showed severe SAH of Fisher grade 4. The patient required surgical treatment by craniectomies and cranial reconstruction, with good performance. The patient eventually regained consciousness and impaired vision was noted. Review of CT head scans revealed previously missed retinal haemorrhages and funduscopy confirmed bilateral vitreous haemorrhage. When the patient was stable we performed a vitrectomy in both eyes for solving the bilateral hemovitreous with good postoperative recovery of visual acuity.
Terson’s syndrome may be related to acute elevation of intracranial pressure, independent of its causes, and may occur with similar incidence in patients with severe brain injury and those with SAH. Gold-standard diagnosis is funduscopy, and retinal haemorrhages may occasionally be seen on CT.
Terson's syndrome occurs frequently following SAH, although it is under-reported. Suspected visual loss following SAH should prompt a search for Terson's syndrome by funduscopy, as its presence is an adverse prognostic factor.