Terson's syndrome leading to fatal outcome in a 36-year-old woman: A case report

Abstract

Terson's syndrome occurs as a result of intraocular hemorrhage associated with intracranial hemorrhage, but was formerly used to describe vitreous hemorrhage associated with Aneurysmal Subarachnoid Hemorrhage (SAH). We present a case of a 36-year-old woman who was not a known hypertensive but presented with a sudden onset of loss of vision in both eyes and a few hours later became deeply unconscious. A computed tomography (CT) scan of the head revealed massive intracerebral hemorrhage with intraventricular extension secondary to severe hypertension and bilateral acute retinal hemorrhages due to the acute rise in intracranial pressure and the recently described ocular glymphatic system provides a novel perspective on the pathophysiology. A diagnosis of Terson's syndrome was made but unfortunately, her clinical condition deteriorated and she expired a few hours after the CT scan. Terson's syndrome is usually associated with poor clinical outcomes from increased intracranial pressure. Implication for clinical practice is that radiologists should critically examine the orbits during imaging for retinal hemorrhage in the setting of severe intracranial hemorrhage for the necessary ophthalmological and neurosurgical interventions to be made since most patients present with sudden onset of loss of vision.

Keywords

• Terson's syndrome
• Intraocular hemorrhage
• Computed tomography
• Intracranial hemorrhage