Download Terson`n syndrome

TERSON’S SYNDROME
Z. Jamaleddine, S. El Haddad, A. El Quessar
Service de Radiologie, Hopital Cheikh Zaid
Rabat - Morocco
Introduction
Terson’s syndrome is the association of vitreous or
retinal haemorrhage with subarachnoid haemorrhage
(SAH).
The diagnosis is typically made fundoscopically.
Objectives
To
describe,
the
clinical,
radiological
characteristics of this syndrome.
To describe the therapeutic indications.
Materials and methods
Three cases hospitalised for subarachnoid haemorrhage
(SAH) and secondary complicated by intravitreous
haemorrhage.
Imaging exploration based on:
Computer tomography 16 bars,
MRI 1.5 Tesla,
Cerebral angiography.
Ocular ultrasonography
haemorrhage.
SAH
intravitreous
All patients were treated by embolisation for the etiology of
SAH : two aneurysms and one AVM.
CASE 1
37 years old woman,
Left hemiplegia.
After several sessions of embolization
Three months later: loss of vision in a right eye
Diagnosis of Terson syndrome
Treatment: Vitrectomy after 5 months
Visual acuity improved immediately
Case 2

A 28 years old male

Headache, vomiting and VI paralysis
t

Ten days later : Blindness of left eye
Diagnosis of Terson syndrome
Treatment: Vitrectomy after 2 months
Recovery of visual acuity
Case 3
Woman of 51 years
One week after: impairment of right visual acuity.
Diagnosis of Terson syndrome
Vitrectomy is programmed, despite a partial
improvement of vision
Discussion
Terson syndrome mentioned for the first time in 1900.
Vitreous haemorrhage: <10% of ruptured intracranial
aneurysm.
Bilateral: 14% - 60% of cases.
Intraocular
haemorrhage
Adult
Children
The rate in %
18 - 41
70
Discussion
Etiology:
The most common
Ruptured aneurysm
cause
AVM
Traumatic cause = very rare.
Clinical manifestation: the significant decrease in visual
acuity is the most common symptom.
Ultrasound search:
Characteristic of intravitreous haemorrhage
Dense,
Mobile: feature of Terson syndrome
Abundant,
Posterior vitreous detachment usually total.
Retinal detachment
Vitrectomy has been shown to be extremely
effective in clearing the vitreous haemorrhage
Indications:
Patients with intraocular bilateral haemorrhage
There is not signs of spontaneous resorption after
1 to 3 month.
Conclusion
It appears necessary to examine visual acuity in case
of subarachnoid haemorrhage for an early diagnosis
and the better treatment of this rare syndrome.