DOI: 10.1055/s-0037-1603105
Síndrome de Terson: avaliação de 53 pacientes com hemorragia subaracnóidea por ruptura de aneurisma
Terson's Sindrome: Assessment of 53 Subaracnoide Hemorrage Patients by Aneurism RupturePublication History
28 November 2016
16 March 2017
Publication Date:
08 May 2017 (eFirst)
Resumo
Objetivo A síndrome de Terson (ST) (hemorragia vítrea) tem sido relatada em pacientes com hemorragia subaracnóidea por ruptura de aneurisma. O presente estudo tem por objetivo avaliar a presença de hemorragia ocular em tais pacientes, visando identificar os que se beneficiariam com o tratamento específico para recuperação do déficit visual.
Métodos Foram estudados, prospectivamente, 53 pacientes com hemorragia subaracnóidea espontânea por ruptura de aneurisma, em relação à presença de hemorragia vítrea, através de fundoscopia indireta, com seguimento de 6 a 12 meses.
Resultados As idades variaram de 17 a 79 anos (média = 45,9 ± 11,7), sendo que 39 pacientes (73%) eram mulheres, e 14, homens (27%). Observou-se que seis pacientes (11%) apresentavam ST, sendo que 83,3% tiveram perda de consciência transitória durante o íctus.
Conclusão A avaliação oftalmológica deve ser realizada rotineiramente nos pacientes portadores de HSAE, especialmente naqueles com pior grau neurológico. Além disso, os pacientes portadores da ST apresentaram pior prognóstico.
Abstract
Purpose The Terson's syndrome is characterized by the presence of vitreous hemorrhage in patients with SAH caused by the rupture of aneurysms. This study is aimed to evaluate the presence of vitreous hemorrhage correlating with the SAH Fisher scale grade as well Hunt Hess scale.
Methods Fifty-three consecutive patients presented with SAH by aneurysms rupture were studied. The patients were evaluated ophthalmologic within the first 48 hours of the ictus. The maximum follow-up was 12 months.
Results In this group of 53 consecutive patients, 6 (11%) had vitreous hemorrhage, 1 being a man (16.6%) and 5 women (83.4%). With regard to the patients with vitreous hemorrhage, 5 had unilateral hemorrhage and 1 had bilateral hemorrhage; however, only 4 (67%) patients had visual complaints; further, 5 patients experienced spontaneous resolution of the vitreous hemorrhage, and only 1 required specific treatment (vitrectomy), with subsequent resolution of the visual deficits.
Conclusions Terson's syndrome seems more frequent that we suppose and therefore, all patients with SAH by aneurysm rupture must be investigated especially those with visual complaining.