Terson Syndrome: Assessment of 53 Patients with Subarachnoid Hemorrhage by a Ruptured Aneurysm

Abstract

Objective Terson syndrome (TS), also known as vitreous hemorrhage, is reported in patients with subarachnoid hemorrhage caused by a ruptured aneurysm. This study aims to evaluate the presence of ocular hemorrhage in such patients, trying to identify those who could benefit from the specific treatment for visual deficit recovery.

Methods Prospective study of 53 patients with spontaneous subarachnoid hemorrhage (SSAH) due to ruptured aneurysm. The patients were evaluated for vitreous hemorrhage through indirect fundoscopy with 6 to 12 months of follow-up.

Results The ages of the patients ranged from 17 to 79 years-old (mean age, 45.9 ± 11.7); 39 patients were female (73%) and 14 were male (27%). Six patients (11%) presented TS, and 83.3% had a transient loss of consciousness during ictus.

Conclusions An ophthalmologic evaluation must be routinely performed in subarachnoid hemorrhage patients, especially in those with worse neurological grade. Moreover, prognosis was bad in TS patients.

Resumo

Objetivo A síndrome de Terson (ST), também conhecida como 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 (HSAE) 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 dos pacientes 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 6 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.

Keywords

spontaneous subarachnoid hemorrhage - aneurysm - vitreous hemorrhage

Palavras-chave

hemorragia subaracnóidea espontânea - aneurisma - hemorragia vítrea

Publication History

Received: 28 November 2016

Accepted: 16 March 2017

Article published online:
08 May 2017

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