The Significance of Intraocular Hemorrhage in Spontaneous Subarachnoid Hemorrhage

ABSTRACT

A sudden increase in intracranial pressure due to spontaneous subarachnoid hemorrhage or head trauma may result in intraocular hemorrhage. To determine the prognostic implications, the incidence of this after SAH, and 157 consecutive patients with spontaneous subarachnoid hemorrhage were prospectively studied by means of indirect fundoscopy. In 20(12.7%) of these patients, intraocular hemorrhage was seen on initial examination. Mean initial Hunt and Hess and Fisher CT grades were higher in SAH patients with intraocular hemorrhage than in those without(3.57 and 3.57 ; 2.56 and 2.70, respectively, the differences were those without statistically significant. The anatomic distribution of ruptured aneurysm was different in patients with intraocular hemorrhage and thoes without. The overall mortality rate was 19%(26 of 137 patients), but 50%(10 of 20 patients) with intraocular hemorrhage died. Based on the results of the above study we can conclude that in cases of spontaneous subarachnoid hemorrhage, intraocular hemorrhage is not infrequent and that its prognosis is poor.