Abstract
Eighty cases of Terson's syndrome including 5 personal cases were reviewed. All of 5 personal cases had severe subarachnoid hemorrhage (SAH) : two were at grade IIIb on admission, two had major attack associated with unconsciousness lasting more than 3 hours, two experienced re-rupture, and one had received no medical treatment for 14 hours after the last attack. CT scan showed thick subarachnoid clots in four (Fisher's group III), intracerebral hematoma in two, and acute hydrocephalus in two. The vitreous hemorrhage was noted on the side on which the SAH was much more severe.
The overall incidence of vitreous hemorrhage was 2.50% (48 patients) of a total of 1918 patients with aneurysmal SAH reviewed in this paper. When the distribution of the aneurysm in this series is taken into consideration, the rate of association of vitreous hemorrhage was significantly higher (p<0.05) in the aneurysm of the anterior communicating artery, and lower in the aneurysm of the middle cerebral artery or the distal anterior cerebral artery. Outcome of SAH associated with vitreous hemorrhage is grave; the patients died or the outcome was poor in 34%, and the outcome was fair in 30%. When the patients survived, however, the prognosis of visual function is relatively good. Functional vision was retained in 69% of patients treated conservatively, and in 92% of patients who underwent vitrectomy.
