Delayed diagnosis of Terson syndrome at a neurorehabilitation unit

Terson syndrome (TS) is often overlooked in acute neurological settings, delaying diagnosis and negatively impacting neurorehabilitation. In cases of severe TS, management with vitrectomy can lead to immediate visual recovery, highlighting the importance of timely recognition. This case report presents a case of TS, diagnosed on arrival at a highly specialised neurorehabilitation centre. A male patient in his late 40s was admitted after a left-sided basal ganglia haemorrhage. Following surgical intervention for elevated intracranial pressure, he was transferred to a neurorehabilitation unit, presenting with global aphasia, hemiparesis and bilateral visual unresponsiveness. Fundoscopic examination confirmed dense bilateral vitreous haemorrhages, diagnosing TS. Right-sided vitrectomy resulted in immediate visual improvement, facilitating rehabilitation. Left-sided vitrectomy followed 6 months later. Early assessment of TS during the initial stages of brain injury with elevated intracranial pressure is crucial. Prompt diagnosis may identify candidates for surgical intervention, facilitating faster visual recovery and enhancing overall rehabilitation outcomes.