Artikel
Terson's syndrome as the only clinical presentation of a subarachnoidal bleeding: case presentation and review of the literature
Das Terson Syndrom als einziger klinischer Hinweis auf eine Subarachnoidalblutung: Fallbericht und Literaturvorstellung
Suche in Medline nach
Autoren
-
L. Dörner
- Klinik für Neurochirurgie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
-
C. Alfke
- Abteilung für Neuroradiologie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
-
H. Barth
- Klinik für Neurochirurgie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
-
H. M. Mehdorn
- Klinik für Neurochirurgie, Universitätsklinikum Schleswig-Holstein, Campus Kiel
| Veröffentlicht: | 4. Mai 2005 |
|---|
Gliederung
Text
Objective
The syndrome of vitreous or retinal hemorrhage occurring consequent to subarachnoidal bleeding is known as Terson's syndrome. It is thought to be related to an elevated ICP and to be accompanied by a bad clinical outcome. We present a case of a ruptured basilar artery aneurysm with bilateral vitreous hemorrhages but without any concomitant clinical symptoms except for a mild neck ache on that day.
Methods
A 61-year-old woman presented with an acute onset of visual loss for week to the ophthalmologist. In fundoscopy he documented a bilateral vitreous hemorrhage. A CCT was suspect for a subarachnoidal bleeding, so the patient was transferred for further diagnostics to our department. To confirm the questionable diagnosis we performed a lumbar puncture proving the suspected diagnosis. A cerebral angiography was performed and the found basilar aneurysm embolized with coils. A week later the patient could be discharged with improving eye sight.
Results
Terson's syndrome is seen in 10 to 20% of patients with subarachnoidal bleeding. Usually it is diagnosed secondary in the late course of the disease for example in the rehabilitation center because of visual deficits. A relation to an elevated ICP is discussed in literature. This case with no signs of intracranial pressure or meningeal irritation is contradictory to this theory and may support other hypotheses.
Conclusions
Terson's syndrome can be the only symptom of SAH caused by a ruptured aneurysm. A relation to an elevated ICP seems at least in this case unlikely. Further investigations to explain the pathophysiology of Terson`s syndrome appear necessary.
