Intracranial Aneurysm Predisposing to Terson's Syndrome: Insights From a Systematic Review

Terson syndrome (TS) is an intraocular hemorrhage associated with subarachnoid hemorrhage (SAH), often linked to specific intracranial aneurysm locations. This review and meta-analysis aim to explore the relationship between aneurysm location and the risk of developing TS. A systematic search was conducted using PubMed and Scopus with the terms "Terson's Syndrome" OR "Terson Syndrome." Studies involving adult patients in English were included. Data on aneurysm location, TS incidence, and clinical outcomes were extracted. The risk of bias was assessed using the Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I) tool and the Case Report (CARE) guidelines. Meta-analysis was performed using Microsoft Excel 2016 (Microsoft® Corp., Redmond, WA, USA). Twenty-one studies with 201 patients were analyzed. Aneurysms in the posterior communicating artery (Pcom) were most frequently associated with TS (24.48%), followed by the anterior communicating artery (Acom) (23.87%). Endovascular coiling was the most common treatment (67.83%), with vitrectomy leading to improved visual outcomes. Aneurysms in the anterior circulation are strongly linked to TS. Early detection and timely surgical interventions, such as vitrectomy, are crucial for improving visual and clinical outcomes in patients with TS.