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

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

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

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

37 years old woman, Left hemiplegia. CASE 1

After several sessions of embolization

Three months later: loss of vision in a right eye

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

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

 Ten days later : Blindness of left eye

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

Woman of 51 years Case 3

One week after: impairment of right visual acuity.

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

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

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

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

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.

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.