Ann Rehabil Med.  2015 Aug;39(4):640-644. 10.5535/arm.2015.39.4.640.

Terson Syndrome in Aneurysmal Subarachnoid Hemorrhage: A Case Report

• Lee SH
• Seo JH
• Park SH
• Won YH
• Ko MH

• KMID: 2148237
• DOI: http://doi.org/10.5535/arm.2015.39.4.640

Abstract

Terson syndrome refers to oculocerebral syndrome of retinal and vitreous hemorrhage associated with spontaneous subarachnoid hemorrhage or all forms of intracranial bleeding. Recent observations have indicated that patients with spontaneous subarachnoid hemorrhage have an 18% to 20% concurrent incidence of retinal and vitreous hemorrhages with about 4% incidence of vitreous hemorrhage alone. Clinical ophthalmologic findings may have significant diagnostic and prognostic value for clinicians. Here we report a 45-year-old female patient who suffered from blurred vision after subarachnoid hemorrhage. She was diagnosed as Terson syndrome. After vitrectomy, she recovered with normal visual acuity which facilitated the rehabilitative process. We also performed visual evoked potentials to investigate abnormalities of visual dysfunction. Based on this case, we emphasize the importance of early diagnosis of Terson syndrome.

Keyword

Terson syndrome; Visual evoked potentials; Subarachnoid hemorrhage

MeSH Terms

Aneurysm*
Early Diagnosis
Evoked Potentials, Visual
Female
Hemorrhage
Humans
Incidence
Middle Aged
Retinaldehyde
Subarachnoid Hemorrhage*
Visual Acuity
Vitrectomy
Vitreous Hemorrhage
Retinaldehyde

Figure

• 

  Fig. 1 Brain computed tomography at the time of admission showing subarachnoid hemorrhage after aneurysmal rupture (A) and brain magnetic resonance imaging (FLAIR image) obtained after right blindness revealing normal finding in right eyeball, suggesting intravitreous bleeding (B).

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  Fig. 2 Latencies of N75, P100, N145 of pattern reversal visual evoked potential (VEP) in the patient with subarachnoid hemorrhage before vitrectomy (A) and after vitrectomy (B). VEP was not evoked in the right eye before vitrectomy. After vitrectomy, VEP showed relatively prolonged P100 latency and low amplitude in the right eye stimulation compared to the left eye stimulation.

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  Fig. 3 Right fundoscopy showing intravitreous hemorrhage before vitrectomy (A) and normal finding after vitrectomy (B).

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