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Terson syndrome: Two case reports.

Moctar Issiaka1, Adil Mchachi2, Rayad Rachid2

  • 1Adult Ophthalmology Department, 20th August Hospital, Ibn Rochd University Hospital, B.P 2698, Casablanca, Morocco.

International Journal of Surgery Case Reports
|December 25, 2021
PubMed
Summary
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Terson syndrome (TS), characterized by vitreous or retinal hemorrhage after subarachnoid hemorrhage, presents varied clinical scenarios. Prompt ophthalmologic evaluation and management, ranging from conservative monitoring to surgical intervention, ensure good visual prognosis in TS patients.

Area of Science:

  • Ophthalmology
  • Neurology
  • Neurosurgery

Background:

  • Terson syndrome (TS) involves vitreous or retinal hemorrhage following subarachnoid hemorrhage (SAH).
  • The incidence of TS post-SAH ranges from 10% to 50%.
  • This report details two distinct TS cases managed at a Casablanca hospital.

Purpose of the Study:

  • To present two cases of Terson syndrome with differing clinical presentations and management strategies.
  • To highlight the importance of timely diagnosis and intervention in Terson syndrome.

Main Methods:

  • Case report of a 55-year-old male with TS secondary to a ruptured internal carotid artery aneurysm.
  • Case report of a 45-year-old male with TS following severe head trauma and extradural hematoma.
  • Utilized neurological management, spontaneous resorption monitoring, ocular ultrasound, OCT, and pars plana vitrectomy.
Keywords:
Intracranial hemorrhageIntraocular hemorrhageRupture of aneurysmTerson syndromeTraumatic brain injury

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Main Results:

  • The first patient experienced decreased visual acuity, managed neurologically with spontaneous hemorrhage resorption and good visual recovery within 3 months.
  • The second patient underwent pars plana vitrectomy with retinal tamponade for retinal detachment and persistent hemorrhage, achieving visual rehabilitation without recurrence after 1 year.
  • Both cases demonstrated favorable final prognoses.

Conclusions:

  • Ophthalmologic evaluation, including specialized examination and radiology (ultrasound, OCT), is crucial for all Terson syndrome patients.
  • Early diagnosis and treatment are essential to prevent visual loss and complications.
  • Management can be conservative with monitoring or surgical (pars plana vitrectomy) depending on the case.