Terson syndrome can be caused by intracranial hemorrhage, subdural or epidural hematoma and severe brain injury but is extremely rare in intraventricular hemorrhage associated with moyamoya disease. Terson syndrome definition of terson syndrome by medical. Tersons syndromerate and surgical approach in patients. Search results terson syndrome national library of. Mystery case responses the mystery case series was initiated by the. Tersons syndrome in subarachnoid hemorrhage and severe. Tersons syndrome was initially described as vitreous hemorrhage secondary to acute subarachnoid hemorrhage, although recent studies have shown that it can also result from traumatic brain injury or even nontraumatic intracerebral hemorrhage 1.
Enfin, une hyponatremie par secretion inappropriee. It is thought to be due to a rapid increase in icp. Although litten reported vitreous haemorrhage in association with subarachnoid haemorrhage in 1881, it was terson who described the syndrome in 1900. Terson syndrome has been described most commonly in subarachnoid hemorrhages due to ruptured cerebral aneurysms. Terson syndrome is defined as intraocular hemorrhage associated with intracranial bleeding. Fishers grade was determined by brain ct scan prior to the operation, and brain ct angiography or dsa provided detailed information about the aneurysm. Tersons syndrome was initially described as vitreous hemorrhage secondary to acute subarachnoid hemorrhage, although recent studies have shown that it can also result from traumatic brain injury or even nontraumatic intracerebral hemorrhage. 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. This photo shows a patient with a large subilm hemorrhage. To improve understanding of vision loss and clinical. Terson syndrome meaning terson syndrome definition ters.
Velikay m, datlinger p, stolba u, wedrich a, binder s, hausmann n. The occurrence of a vitreous hemorrhage of the human eye in association with subarachnoid hemorrhage. Ct head scan revealed a tentorial acute subdural hemorrhage asdh and posterior globe hyperdensities suggestive of intraocular blood with a right posterior communicating artery aneurysm on cerebral angiography figure 1. Ocular ultrasonography in patients with subarachnoid. Garfinkle am, danys ir, nicolle da, colohan art, brem s. There were more than twice as many women as men, a finding consistent with the sex. The syndrome of retinal or vitreous hemorrhage in association with subarachnoid hemorrhage sah is known as tersons syndrome. Subarachnoid haemorrhage sah associated with vitreous haemorrhage was first described by french ophthalmologist albert terson in 1900. Tersons syndrome is a condition in which intracranial bleeding is associated with hemorrhage inside the eye. Terson syndrome terson, vitreous, retinal, and subhyaloid hemorrhages associated with subarachnoid hemorrhage.
These frequently arise after rupture of an intracranial aneurysm, or dilated vessel in the brain. Terson syndrome was originally used to describe a vitreous hemorrhage arising from aneurysmal subrarachnoid hemorrhage. In seven cases of tersons syndrome, an elevated, domeshaped, membrane was detected in the posterior pole by ophthalmoscopy, echography, or during pars plana vitrectomy. Terson syndrome caused by intraventricular hemorrhage. It has been hypothesized that the bleeding results when a sudden rise in intracranial pressure causes rupture of retinal and peripapillary vessels. Vitreous hemorrhage of the eye can also occur in association with intracranial hemorrhage and elevated intracranial pressure icp. Incidence, morbidity, and mortality of terson syndrome in. We describe six eyes from three patients with terson syndrome. Benbouzid a, benfdil n, gaboune l, moussaoui k, baha t, moutaouakil a marrakech, maroc.
In seven cases of tersons synd rome, an elevated, domeshaped, membrane was detected in the posterior pole by ophthalmoscopy, echography, or during pars plana vitrectomy. Intraocular hemorrhage can be a subretinal, retinal, preretinal, subhyaloidal, or intravitreal hemorrhage. View the article pdf and any associated supplements and figures for a period of 48 hours. Most cases of tersons syndrome involve patients who have had subarachnoid hemorrhages. Terson syndrome is the presence of vitreous or subinternal limiting membrane ilm hemorrhage after acute intracranial hemorrhage. Practical incidence and risk factors of tersons syndrome.
It is the commonest congenital cause of mental retardation. Terson syndrome is usually described in correlation with ruptured cerebral vessel aneurysms, mainly in three locations. Symptomes et signes cliniques dune hemorragie sousarachnoidienne. Fifteen eyes of 1 1 male patients four bilateral with the diagnosis of terson syndrome underwent vitreous surgery.
Tersons syndrome is characterised by vitreous haemorrhage accompanying subarachnoid or any other form of intracranial haemorrhage. Originally described in 1900 by albert terson, the syndrome has an incidence of 2. Cranial encephalic trauma and spontaneous rupture of intracranial aneurysm were the. Tersons syndrome in spontaneous subarachnoid hemorrhage. Unilateral vitreous haemorrhage secondary to caudal.
Pars plana vitrectomy was performed in one eye twelve weeks, and in four eyes six months after the acute event. Subinternal limiting membrane and subhyaloid haemorrhage in terson syndrome. Terson s syndrome is a condition in which intracranial bleeding is associated with hemorrhage inside the eye. Retinal detachment with severe proliferative vitreoretinopathy in terson syndrome. Most cases of terson s syndrome involve patients who have had subarachnoid hemorrhages.
There were more than twice as many women as men, a finding. The sudden elevation of the intracranial pressure has a crucial role in tersons syndrome. Terson syndrome or terson s syndrome is the occurrence of a vitreous hemorrhage of the human eye in association with subarachnoid hemorrhage. Downs syndrome occurs when a person has three copies of chromosome 21. Terson syndrome is a relatively common complication of subarachnoid hemorrhage that may require early surgical attention to prevent longterm vision loss and hasten recovery. The ocular pathology of tersons syndrome fang ko, md, david l. To analyze the incidence, clinical course, ophthalmic findings, and prognosis of the patients with intracranial bleeding and tersons syndrome.
Noninvasive screening based on biochemical analysis of maternal serum or urine, or fetal ultrasound measurements, allows. Pointofcare handheld ophthalmic ultrasound in the diagnosis and evaluation of raised intracranial pressure and terson syndrome. A macular double ring sign may be seen with the inner ring caused subilm hemorrhage and the outer ring caused by subhyaloid hemorrhage although intraocular hemorrhages most frequently develop in the first hour after sah, terson syndrome can have a delayed onset, with reports of intraocular hemorrhage occurring. It corresponds to a subhyloid hemorrhage with involvement of the vitreous in the setting of acute aneurysmal subarachnoid hemorrhage.
Three prospective studies satisfied the inclusion criteria. A 36yearold woman presented with acute severe headache and generalized tonicclonic seizures. Terson syndrome was described in 1900 by alfres terson, a french ophthalmologist. Hemorragie meningee non traumatique college des enseignants. Terson syndrome or tersons syndrome is the occurrence of a vitreous hemorrhage of the human eye in association with subarachnoid hemorrhage. Terson syndrome american journal of neuroradiology. Tersons syndromedrate and surgical approach in patients with subarachnoid hemorrhage a prospective interdisciplinary study christos skevas, md,1, patrick czorlich, md,2, volker knospe, md,1 birthe stemplewitz, md,1 gisbert richard, md,1 manfred westphal, md,2 jan regelsberger, md,2 lars wagenfeld, md1 objectives. Although early studies attempted to link this syndrome with aneurysms of the anterior communicating artery, statistical analysis has not correlated it with a specific aneurysmal location. Terson syndrome ts is the presence of any intraocular hemorrhage, including vitreous, subhyaloid, intraretinal, or subretinal bleeding, in patients with intracranial hemorrhage or traumatic brain injury.