Terson syndrome in aneurysmal subarachnoid hemorrhage—its relation to intracranial pressure, admission factors, and clinical outcome

Joswig, Holger; Epprecht, Lorenz; Valmaggia, Christophe; Leschka, Sebastian; Hildebrandt, Gerhard; Fournier, Jean–Yves; Stienen, Martin N.

doi:10.1007/s00701-016-2766-8

Cited by 29 publications

(35 citation statements)

References 32 publications

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“…Most patients have bilateral vitreous hemorrhage, with the most prevalent aneurysms in the anterior circulation. 9,11,22,23 The mean age was 55.2 years in patients with TS compared to 52 years for patients without TS and there was no significant difference regarding sex. The HH scale was higher in patients with TS, with an increased risk of mortality of 4.8 times in patients.…”

Section: Joswig Et Al Retrospectively Evaluated 36 Patients With Ts Amentioning

confidence: 87%

“…Patients with TS were more likely to develop increased ICP (mean initial ICP of 26 ± 6.9 mmHg vs non-TS 15 ± 5.8 mmHg), in some ventriculostomy was performed and all showed unsatisfactory results in the follow-up. 9 56.9% of the cases analyzed by Czorlich P. et al had an ICP > 25 mmHg. However, some patients had a pathological increase in ICP, favorable results and did not develop TS, a fact reported in both studies.…”

Section: Joswig Et Al Retrospectively Evaluated 36 Patients With Ts Amentioning

confidence: 91%

“…However, some patients had a pathological increase in ICP, favorable results and did not develop TS, a fact reported in both studies. 9,10,16 In the systemic review carried out by McCarron et al, the number of TS cases in patients with SAH ranged from 3% (retrospective) to 13% (prospective). Most patients have bilateral vitreous hemorrhage, with the most prevalent aneurysms in the anterior circulation.…”

Section: Joswig Et Al Retrospectively Evaluated 36 Patients With Ts Amentioning

confidence: 99%

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Terson sign:

Severo¹,

Andrade²,

Júnior³

et al. 2020

jmm

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Terson's sign (TS) is classically defined as vitreous hemorrhage associated with subarachnoid hemorrhage of aneurysmal origin, being an important predictor of severity, indicating greater morbidity and mortality when compared to patients without the sign. The objective of this study is to review the relationship of Terson syndrome/Terson sign with the prognosis of aneurysmal subarachnoid hemorrhage. A search for original articles, research and case reports was performed on the PubMed, Scielo, Cochrane and ScienceDirect platform, with the following descriptors: Terson sign and subarachnoid hemorrhage. Retrospective, prospective articles and case reports published in the last 5 years and which were in accordance with the established objective and inclusion criteria were selected. Ten (10) articles were selected, in which the available results show an unfavorable prognostic relationship of TS and subarachnoid hemorrhage, because these patients had a worse clinical status assessed on the Glasgow scales ≤ 8, Hunt & Hess > III, Fisher > 3, in addition to intracranial hypertension and location of the aneurysm in the anterior communicating artery complex. The early recognition of this condition described by Albert Terson in 1900 brought an important contribution to neurosurgery, being recognized until nowadays.

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Section: Joswig Et Al Retrospectively Evaluated 36 Patients With Ts Amentioning

confidence: 87%

Section: Joswig Et Al Retrospectively Evaluated 36 Patients With Ts Amentioning

confidence: 91%

Section: Joswig Et Al Retrospectively Evaluated 36 Patients With Ts Amentioning

confidence: 99%

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Terson sign:

Severo¹,

Andrade²,

Júnior³

et al. 2020

jmm

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“…However, in females, the incidence rate of Terson syndrome was higher in the coil embolization group, and the reason for this is unclear. Factors known to potentially be related to the occurrence of Terson syndrome, including the poor neurological condition of SAH 7,15 , a history of transient or prolonged coma before admission 4,16–18 , increased intracranial pressure 18 , and location, laterality, and size of aneurysms 19 , could not be investigated with the health claims data presented here. In order to determine whether the higher incidence in the coil embolization group in females is a meaningful result, these confounding factors need to be adjusted.…”

Section: Discussionmentioning

confidence: 99%

Incidence of Terson Syndrome in Treated Subarachnoid Hemorrhage in South Korea: a National Health Insurance Database Study

Hong

Seong

Yeom

et al. 2019

Sci Rep

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The aim of this study is to investigate the incidence and mortality of Terson syndrome in patients with treated subarachnoid hemorrhage (SAH) in South Korea. In this nationwide, population-based study, we used the National Health Insurance(NHI) database (2011–2015) to identify patients aged ≥18 years. Newly diagnosed non-traumatic SAH, treated using clipping or coil embolization, were identified, and Terson syndrome was defined as newly diagnosed retinal or vitreous hemorrhage within 3 months of SAH diagnosis. We identified 22,864 patients with treated SAH (tSAH), 196 of whom had Terson syndrome, with the cumulative incidence during 5 years of 0.86% (95% CI: 0.74–0.98): 1.10% (95% CI: 0.88–1.33) in men and 0.71% (95% CI, 0.58–0.85) in women. The cumulative incidence of Terson syndrome in patients aged under 40 was higher than in those aged 40 or over (1.41% vs. 0.81%; p = 0.007). The mortality rate of Terson syndrome in patients with tSAH was not different from that in those without Terson syndrome (4.08% vs. 7.30%; p = 0.089). This was the first nationwide epidemiological study of Terson syndrome using a population-based database. The incidence of Terson syndrome in patients with tSAH was higher in those age under 40 than in those aged 40 or over.

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“…Different predisposing factors need to be added to explain these two syndromes [1,3]. The most important factors could be the increased intraocular pressure for the silicone migration into the brain or the increased intracranial pressure for the TS with a possible positive correlation between the TS and ICP [5]. This Bparavascular retino-orbital continuity^could permit a transmission of fluid with two possible directions: from the subarachnoid space to the vitreous cavity and from the intraocular space to the subarachnoid space [6].…”

mentioning

confidence: 99%