Terson's Syndrome: Diagnostic Comparison of Ocular Sonography and CT

Bäuerle, Jochen; Gross, Nikolai; Egger, Karl; Neubauer, Jakob; Niesen, Wolf‐Dirk; Buttler, Klaus-Jürgen; Lagrèze, Wolf A.; Reinhard, Matthias

doi:10.1111/jon.12285

Cited by 18 publications

(17 citation statements)

References 29 publications

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“…Serial ONSD measurements can be used to follow the progression of ICP in the operating room or the intensive care unit. Vitreous hemorrhage or Terson syndrome can also be easily diagnosed using ocular ultrasound and is associated with poor prognosis in subarachnoid hemorrhage [39].…”

Section: Whobus and The Encephalopathic Patientmentioning

confidence: 99%

Whole body ultrasound in the operating room and intensive care unit

Denault¹,

Canty

Azzam

et al. 2019

Korean J Anesthesiol

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Whole body ultrasound can be used to improve the speed and accuracy of evaluation of an increasing number of organ systems in the critically ill. Cardiac and abdominal ultrasound can be used to identify the mechanisms and etiology of hemodynamic instability. In hypoxemia or hypercarbia, lung ultrasound can rapidly identify the etiology of the condition with an accuracy that is equivalent to that of computed tomography. For encephalopathy, ocular ultrasound and transcranial Doppler can identify elevated intracranial pressure and midline shift. Renal and bladder ultrasound can identify the mechanisms and etiology of renal failure. Ultrasound can also improve the accuracy and safety of percutaneous procedures and should be currently used routinely for central vein catheterization and percutaneous tracheostomy.

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Section: Whobus and The Encephalopathic Patientmentioning

confidence: 99%

Whole body ultrasound in the operating room and intensive care unit

Denault¹,

Canty

Azzam

et al. 2019

Korean J Anesthesiol

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“…Similarly, Terson syndrome is an adverse prognostic feature in patients with SAH. [9][10][11][12]28 Although the pathogenesis of Terson syndrome remains unclear, it is relatively common occurring in approximately 13% of patients hospitalized for SAH. 28 Recognition of this syndrome using US could further help clinicians stratify patients; however, caution must be used as distinguishing vitreous hemorrhage from other benign vitreous pathologies may be difficult for non-ophthalmologist users.…”

Section: Discussionmentioning

confidence: 99%

“…[2][3][4][5][6][7][8] As a complication of SAH, vitreous hemorrhage can also occur in such patients and is known as Terson syndrome. [9][10][11][12] Its presence is associated with higher SAH grade and poorer outcome. 10 The purpose of this report is to illustrate the ultrasonographic technique using a handheld twodimensional linear US probe for obtaining ONSD measurements.…”

Section: Résumémentioning

confidence: 99%

Point-of-care handheld ophthalmic ultrasound in the diagnosis and evaluation of raised intracranial pressure and Terson syndrome: a description of two cases

Palermo

Bojanowski

Langevin

et al. 2019

Can J Anesth/J Can Anesth

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“…The agreement between observers for the detection of ocular hemorrhage was good (K: 0.78). 51 In a prospective study of 36 patients with SAH, 6 of whom (16.7%) had TS, ventriculostomy was required in 80.5% of patients, and those with TS had higher intracranial pressures (40 vs 15 cm H 2 O; P ¼ .003). Terson syndrome was detected on CT scans with a sensitivity of 50%, a specificity of 98.4%, a positive predictive value of 83.3%, and a negative predictive value of 92.4%.…”

mentioning

confidence: 97%

Can Baseline Computed Tomography Scans Be Used to Identify Patients at High Risk of Vision Loss due to Terson Syndrome?

Stewart

Hasan

Collins

et al. 2020

American Journal of Ophthalmology

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To determine if routinely performed computed tomographic (CT) scanning in patients with aneurysmal subarachnoid hemorrhages (aSAHs) is sufficient to identify patients at high risk of vision loss due to Terson syndrome (TS). METHODS: Consecutive patients with a diagnosis of aSAH admitted to the neurologic intensive care unit of a regional referral hospital over a 3-year period were prospectively evaluated. Head CT scans performed in the emergency department were assessed for the presence of a ''crescent sign'' (evidence of significant subinternal limiting membrane hemorrhage). Dilated funduscopic examinations were performed by an ophthalmologist, masked to the results of the CT scan, to identify retinal and vitreous hemorrhages consistent with TS. Retinal hemorrhages were categorized according to size-those smaller than 2 mm in diameter were deemed low risk (lrTS) for vision loss and those larger than 2 mm in diameter were deemed high risk (hrTS) for vision loss. RESULTS: One hundred seventeen patients with aSAH were enrolled in the study. The overall incidence of TS was 24.9% (29 of 117 patients; 12 were bilateral). Compared to patients without TS, those with TS had a higher Fisher Hemorrhage Grade and a lower mean (±standard deviation) GCS score (8.66 ± 4.97 vs 12.09 ± 1.10; P < 0.001). The CT crescent sign was positive in 7 patients (6.0%), 6 (5.1%; 2 were bilateral) of whom were found to have hrTS. Of the 110 patients without a CT crescent sign, 88 (75.1%) patients did not have TS, 21 had lrTS, and 1 patient had hrTS in one eye. The CT crescent sign was highly sensitive (85.7%) and specific (99.1%) for diagnosing hrTS. CONCLUSION: The CT crescent sign is a highly sensitive and specific marker for hrTS. CT scanning may replace routine ophthalmologic examinations to identify patients at risk of vision loss due to aSAH. (Am J

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Terson's Syndrome: Diagnostic Comparison of Ocular Sonography and CT

Abstract: Ocular sonography identifies SAH-related preretinal and vitreous hemorrhages with high accuracy and is superior to standard head CT. It may be considered as new and useful bedside diagnostic tool for routine clinical care of patients with SAH.

Cited by 18 publications

References 29 publications

Whole body ultrasound in the operating room and intensive care unit

Whole body ultrasound in the operating room and intensive care unit

Point-of-care handheld ophthalmic ultrasound in the diagnosis and evaluation of raised intracranial pressure and Terson syndrome: a description of two cases

Can Baseline Computed Tomography Scans Be Used to Identify Patients at High Risk of Vision Loss due to Terson Syndrome?

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