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

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. 37 years old woman, Left hemiplegia. CASE 1

7. After several sessions of embolization

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

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

10.  A 28 years old male  Headache, vomiting and VI paralysis t Case 2

12.  Ten days later : Blindness of left eye

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

14. Woman of 51 years Case 3

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

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

18. Discussion Terson syndrome mentioned for the first time in 1900. Vitreous haemorrhage: <10% of ruptured intracranial aneurysm. Bilateral: 14% - 60% of cases. Intraocular haemorrhage AdultChildren The rate in %18 - 41 70

19. 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

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

21. 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.

22. 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.