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CC BY-NC-ND 4.0 · Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2018; 37(03): 163-166
DOI: 10.1055/s-0036-1581085
Original Article | Artigo Original
Thieme Revinter Publicações Ltda Rio de Janeiro, Brazil

Hemorragia Vítrea após Rotura de Aneurisma Cerebral: Síndrome de Terson

Article in several languages: English | português
Rodrigo Becco de Souza
1   Discipline of Neurosurgery, Department of Surgery, Faculty of Medical Sciences, Santa Casa de São Paulo, São Paulo, SP, Brazil
,
Guilherme Brasileiro de Aguiar
1   Discipline of Neurosurgery, Department of Surgery, Faculty of Medical Sciences, Santa Casa de São Paulo, São Paulo, SP, Brazil
,
Sarah L.P. Weber
1   Discipline of Neurosurgery, Department of Surgery, Faculty of Medical Sciences, Santa Casa de São Paulo, São Paulo, SP, Brazil
,
Juan Antonio Castro Flores
1   Discipline of Neurosurgery, Department of Surgery, Faculty of Medical Sciences, Santa Casa de São Paulo, São Paulo, SP, Brazil
,
Mario Luiz Marques Conti
1   Discipline of Neurosurgery, Department of Surgery, Faculty of Medical Sciences, Santa Casa de São Paulo, São Paulo, SP, Brazil
,
José Carlos Esteves Veiga
1   Discipline of Neurosurgery, Department of Surgery, Faculty of Medical Sciences, Santa Casa de São Paulo, São Paulo, SP, Brazil
› Author Affiliations
Further Information

Publication History

16 November 2015

02 February 2016

Publication Date:
14 April 2016 (online)

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Resumo

Introdução A síndrome de Terson é descrita como uma hemorragia intraocular consequente a hemorragia subaracnóidea espontânea (HSAe). O objetivo do presente artigo é descrever os casos de pacientes submetidos a tratamento neurocirúrgico de aneurisma cerebral roto diagnosticados com síndrome de Terson.

Métodos Foram incluídos no estudo os pacientes com diagnóstico de HSAe por rotura de aneurisma cerebral submetidos a tratamento em nosso serviço de neurocirurgia no período de dezembro de 2009 a dezembro de 2010. Os pacientes foram acompanhados por um período mínimo de 20 meses. Realizamos ainda a revisão da literatura e comparamos os dados obtidos com os disponíveis na literatura atual.

Resultados Foram incluídos no estudo 34 pacientes. Destes, 18 foram submetidos a tratamento endovascular e 16 foram submetidos a clipagem microcirúrgica. No grupo, houve mortalidade de 14,7% (cinco pacientes), mesmo percentual de pacientes que receberam diagnóstico de síndrome de Terson. Em relação à avaliação oftalmológica, todos os pacientes apresentaram hemovítreo ao exame de ultrassonografia ocular, sendo unilateral em apenas dois pacientes. Houve melhora da acuidade visual em todos os pacientes, sendo incompleta em apenas um deles.

Conclusão Síndrome de Terson é relativamente comum, e, por estar associada a maior mortalidade e ter um tratamento eficaz, deve ser investigada em todos os pacientes com HSAe.

Palavras-Chave

hemorragia vítrea - aneurisma cerebral - hemorragia subaracnóidea - vitrectomia
 

  • References

  • 1 McCarron MO, Alberts MJ, McCarron P. A systematic review of Terson's syndrome: frequency and prognosis after subarachnoid haemorrhage. J Neurol Neurosurg Psychiatry 2004; 75 (03) 491-493
    CrossrefPubMedGoogle Scholar
  • 2 Terson A. De L'hémorrhagie dans Le corps vitre au cours de L'émorrhagie cerebrale. Clin Ophthalmol 1900; 6: 309-312
    PubMedGoogle Scholar
  • 3 Fahmy JA. Fundal haemorrhages in ruptured intracranial aneurysms. I. Material, frequency and morphology. Acta Ophthalmol (Copenh) 1973; 51 (03) 289-298
    PubMedGoogle Scholar
  • 4 Garfinkle AM, Danys IR, Nicolle DA, Colohan AR, Brem S. Terson's syndrome: a reversible cause of blindness following subarachnoid hemorrhage. J Neurosurg 1992; 76 (05) 766-771
    CrossrefPubMedGoogle Scholar
  • 5 Fountas KN, Kapsalaki EZ, Lee GP. , et al. Terson hemorrhage in patients suffering aneurysmal subarachnoid hemorrhage: predisposing factors and prognostic significance. J Neurosurg 2008; 109 (03) 439-444
    CrossrefPubMedGoogle Scholar
  • 6 He T, Wu LN, Chen B, Xing YQ. [Incidence and relative factors of Terson syndrome in patients with aneurysmal subarachnoid hemorrhage]. Zhonghua Yan Ke Za Zhi 2011; 47 (12) 1096-1101
    PubMedGoogle Scholar
  • 7 Doubler FH, Marlow SB. A case of hemorrhage into the optic nerve sheath as a direct extension from a diffuse intra-meningeal hemorrhage caused by rupture of an aneurysm of a cerebral artery. Arch Ophthalmol 1917; 46: 533-536
    PubMedGoogle Scholar
  • 8 Medele RJ, Stummer W, Mueller AJ, Steiger HJ, Reulen HJ. Terson's syndrome in subarachnoid hemorrhage and severe brain injury accompanied by acutely raised intracranial pressure. J Neurosurg 1998; 88 (05) 851-854
    CrossrefPubMedGoogle Scholar
  • 9 Castren JA. Pathogenesis and treatment of Terson-syndrome. Acta Ophthalmol (Copenh) 1963; 41: 430-434
    PubMedGoogle Scholar
  • 10 Riddoch G, Goulden C. On the relationship between subarachnoid and intraocular haemorrage. Br J Ophthalmol 1925; 9 (05) 209-233
    CrossrefPubMedGoogle Scholar
  • 11 Manschot WA. The fundus oculi in subarachnoid haemorrhage. Acta Ophthalmol (Copenh) 1944; 22: 281-299
    PubMedGoogle Scholar
  • 12 Shaw Jr HE, Landers MB, Sydnor CF. The significance of intraocular hemorrhages due to subarachnoid hemorrhage. Ann Ophthalmol 1977; 9 (11) 1403-1405
    PubMedGoogle Scholar
  • 13 Shaw Jr HE, Landers III MB. Vitreous hemorrhage after intracranial hemorrhage. Am J Ophthalmol 1975; 80 (02) 207-213
    CrossrefPubMedGoogle Scholar
  • 14 Körner F, Meier-Gibbons F. [Vitrectomy in Terson syndrome. Report of 18 cases]. Klin Monatsbl Augenheilkd 1992; 200 (05) 468-471 (Ger.)
    Article in Thieme ConnectPubMedGoogle Scholar
  • 15 Roux FX, Panthier JN, Tanghe YM. , et al. [Terson's syndrome and intraocular complications in meningeal hemorrhages (26 cases)]. Neurochirurgie 1991; 37 (02) 106-110
    PubMedGoogle Scholar
  • 16 Schultz PN, Sobol WM, Weingeist TA. Long-term visual outcome in Terson syndrome. Ophthalmology 1991; 98 (12) 1814-1819
    CrossrefPubMedGoogle Scholar
  • 17 Garweg JG, Koerner F. Outcome indicators for vitrectomy in Terson syndrome. Acta Ophthalmol 2009; 87 (02) 222-226
    CrossrefPubMedGoogle Scholar