RESUMEN
Objetivo A síndrome de Terson (ST), também conhecida como hemorragia vítrea, é relatada em pacientes com hemorragia subaracnóide causada por um aneurisma rompido. Este estudo tem como objetivo avaliar a presença de hemorragia ocular nesses pacientes, buscando identificar aqueles que poderiam se beneficiar do tratamento específico para a recuperação do déficit visual. Métodos Estudo prospectivo de 53 pacientes com hemorragia subaracnóide espontânea (SSAH) por aneurisma rompido. Os pacientes foram avaliados quanto à hemorragia vítrea por fundoscopia indireta com 6 a 12 meses de seguimento. Resultados A idade dos pacientes variou de 17 a 79 anos (média de 45,9 ± 11,7); 39 pacientes eram do sexo feminino (73%) e 14 do sexo masculino (27%). Seis pacientes (11%) apresentaram ST e 83,3% apresentaram perda transitória de consciência durante a ictus. Conclusões Uma avaliação oftalmológica deve ser realizada rotineiramente em pacientes com hemorragia subaracnóide, especialmente naqueles com pior grau neurológico. Além disso, o prognóstico foi ruim em pacientes com ST.
Asunto(s)
Humanos , Masculino , Femenino , Rotura de la Aorta/diagnóstico por imagen , Hemorragia Subaracnoidea/diagnóstico por imagen , Hemorragia Vítrea/diagnóstico por imagen , Hemorragia Retiniana/diagnóstico por imagen , Técnicas de Diagnóstico Oftalmológico , Rotura de la Aorta/mortalidad , Punción Espinal/métodos , Hemorragia Subaracnoidea/mortalidad , Vitrectomía/métodos , Hemorragia Vítrea/mortalidad , Hemorragia Retiniana/mortalidad , Angiografía Cerebral/métodos , Distribución de Chi-Cuadrado , Estudios ProspectivosRESUMEN
Objective Terson syndrome (TS), also known as vitreous hemorrhage, is reported in patients with subarachnoid hemorrhage caused by a ruptured aneurysm. This study aims to evaluate the presence of ocular hemorrhage in such patients, trying to identify those who could benefit from the specific treatment for visual deficit recovery. Methods Prospective study of 53 patients with spontaneous subarachnoid hemorrhage (SSAH) due to ruptured aneurysm. The patients were evaluated for vitreous hemorrhage through indirect fundoscopy with 6 to 12 months of follow-up. Results The ages of the patients ranged from 17 to 79 years-old (mean age, 45.9 11.7); 39 patients were female (73%) and 14 were male (27%). Six patients (11%) presented TS, and 83.3% had a transient loss of consciousness during ictus. Conclusions An ophthalmologic evaluation must be routinely performed in subarachnoid hemorrhage patients, especially in those with worse neurological grade. Moreover, prognosis was bad in TS patients.
Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Rotura de la Aorta/complicaciones , Hemorragia Subaracnoidea/etiología , Hemorragia Vítrea/mortalidad , Hemorragia Vítrea/diagnóstico por imagen , Rotura de la Aorta/mortalidad , Rotura de la Aorta/diagnóstico por imagen , Pronóstico , Hemorragia Subaracnoidea/mortalidad , Hemorragia Subaracnoidea/diagnóstico por imagen , Distribución de Chi-Cuadrado , Interpretación Estadística de Datos , Técnicas de Diagnóstico OftalmológicoRESUMEN
A case of bilateral persistent hyperplastic primary vitreous (PHPV) in a 3-month-old male infant, who had bilateral leukokoria, is presented. The child was referred for imaging with a clinical suspicion of retinoblastoma. Gray-scale ultrasound evaluation revealed an echogenic band in the posterior segment of both globes, extending from the posterior surface of the lens capsule to the optic disc. Doppler examination revealed the presence of arterial flow in the band in both globes. Associated echogenic hemorrhage was also seen, which was confirmed by computed tomography. Most cases of PHPV are sporadic and unilateral, and bilateral PHPV is rare. The imaging features in this case suggest the diagnosis of bilateral PHPV and differentiate it from retinoblastoma. This entity, although infrequent, should be considered in the differential diagnosis while evaluating bilateral leukokoria.