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Updated: Jul 11, 2026
04:02
System for Focal, Closed-System Central Nervous System Injury
Published on: November 29, 2024
Terson syndrome with bilateral optic nerve sheath hemorrhage
Chiaki D Gauntt1, Richard G Sherry, Chithra Kannan
1Department of Neurology, University of Louisville School of Medicine, Louisville, KY, USA. cgauntt@gaunttmd.com
Summary
Ruptured brain aneurysms can cause Terson syndrome, leading to vision loss. This case highlights CT findings of Terson syndrome with optic nerve sheath hemorrhage after an aneurysm rupture.
Area of Science:
- Neuro-ophthalmology
- Neuroradiology
- Vascular Neurology
Background:
- Subarachnoid hemorrhage (SAH) from anterior choroidal artery aneurysm rupture can lead to neurological and ophthalmological complications.
- Terson syndrome, characterized by intraocular hemorrhage following intracranial hemorrhage, is a known but infrequently reported association.
Observation:
- A 53-year-old male presented with acute headache and altered mental status.
- Preoperative CT revealed subarachnoid hemorrhage, bilateral optic nerve sheath hemorrhage, and bilateral intraocular hemorrhage.
- Ophthalmoscopy and B-scan ultrasound confirmed vitreous hemorrhages consistent with Terson syndrome.
Findings:
- This case presents the first computed tomography (CT) documentation of Terson syndrome manifesting with bilateral optic nerve sheath hemorrhage.
- The findings underscore the utility of CT in diagnosing the ophthalmological sequelae of aneurysmal SAH.
Implications:
- Early recognition of Terson syndrome is crucial for ophthalmological management and visual prognosis in patients with aneurysmal rupture.
- This report expands the neuroradiological understanding of Terson syndrome, emphasizing optic nerve sheath hemorrhage as a CT-detectable sign.
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