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TERSON’S SYNDROME

TERSON’S SYNDROME. Service de Radiologie, Hopital Cheikh Zaid Rabat - Morocco. Z. Jamaleddine, S. El Haddad, A. El Quessar. Introduction. Terson’s syndrome is the association of vitreous or retinal haemorrhage with subarachnoid haemorrhage (SAH).

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TERSON’S SYNDROME

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  1. TERSON’S SYNDROME Service de Radiologie, Hopital Cheikh Zaid Rabat - Morocco Z. Jamaleddine, S. El Haddad, A. El Quessar

  2. Introduction • Terson’s syndrome is the association of vitreous or retinal haemorrhage with subarachnoid haemorrhage (SAH). • The diagnosis is typically made fundoscopically.

  3. Objectives • To describe, the clinical, radiological characteristics of this syndrome. • To describe the therapeutic indications.

  4. Materials and methods • Three cases hospitalised for subarachnoid haemorrhage (SAH) and secondary complicated by intravitreous haemorrhage. • Imaging exploration  based on: • Computer tomography 16 bars, • MRI 1.5 Tesla,  • Cerebral angiography.  • Ocular ultrasonography intravitreous haemorrhage. • All patients were treated by embolisation for the etiology of SAH : two aneurysms and one AVM. SAH

  5. CASE 1 • 37 years old woman, • Left hemiplegia.  

  6. After several sessions of embolization

  7. Three months later: loss of vision in a right eye 

  8. Diagnosis of Terson syndrome  • Treatment: Vitrectomy after 5 months • Visual acuity improved immediately

  9. Case 2 •   A 28 years old male •   Headache, vomiting and VI paralysis  • t

  10. Ten days later : Blindness of left eye

  11. Diagnosis of Terson syndrome  • Treatment: Vitrectomy after 2 months • Recovery of visual acuity

  12. Case 3 • Woman of 51 years

  13. One week after: impairment of right visual acuity.

  14. Diagnosis of Terson syndrome  • Vitrectomy is programmed, despite a partial improvement of vision

  15. Discussion • Terson syndrome mentioned for the first time in 1900. • Vitreous haemorrhage: <10% of ruptured intracranial aneurysm. • Bilateral: 14% - 60% of cases.

  16. Discussion • Etiology: • Ruptured aneurysm • AVM • Traumatic cause = very rare. • Clinical manifestation: the significant decrease in visual acuity is the  most  common symptom. The most common cause

  17. Ultrasound search: • Characteristic of intravitreous haemorrhage • Dense, • Mobile: feature of Terson syndrome • Abundant, • Posterior vitreous detachment usually total. • Retinal detachment

  18. Vitrectomy has been shown to be extremely effective in clearing the vitreous haemorrhage • Indications: • Patients with intraocular bilateral haemorrhage  • There is not signs of spontaneous resorption after 1 to 3 month.

  19. Conclusion • It appears necessary to examine visual acuity in case of subarachnoid haemorrhage for an early diagnosis and the better treatment of this rare syndrome.

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