Terson Syndrome Workup

  • Author: Richard J Ou, MD; Chief Editor: Hampton Roy Sr, MD   more...
 
Updated: Apr 3, 2012
 

Laboratory Studies

  • Terson syndrome can be diagnosed by its unique clinical presentation of simultaneous intracranial and intraocular hemorrhage. A thorough history must be obtained to rule out causes of preexisting intraocular hemorrhages (eg, diabetic retinopathy, age-related macular degeneration, sickle cell disease, intraocular tumor). In cases associated with trauma, a posterior vitreous detachment, retinal break, or retinal detachment also must be ruled out.
  • Sickle cell preparation
  • Glucose level and glucose tolerance test to rule out diabetes
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Imaging Studies

  • Neuroimaging studies, including CT scan, MRI, or angiography, are necessary to document intracranial hemorrhage.
  • B-scan ultrasound may be necessary to determine the severity of vitreous hemorrhage and to rule out a retinal detachment if no view to the posterior pole is possible, particularly in the setting of trauma.
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Other Tests

  • Examination of the cerebrospinal fluid should be deferred to a neurologist.
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Diagnostic Procedures

  • Both a history and a clinical examination are indicated to help diagnose this condition.
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Histologic Findings

Pathologic specimens of patients with Terson syndrome have shown abundant erythrocytes with occasional leukocytes in the vitreous, subhyaloidal and subinternal limiting membrane space, and retina. Clinical case reports have documented subretinal blood, but this is not as common. Epiretinal membranes examined in Terson syndrome show glial cells and basement membrane material.

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Staging

No staging currently exists.

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Contributor Information and Disclosures
Author

Richard J Ou, MD  Clinical Assistant Professor, Baylor College of Medicine; Attending Physician and Consultant, Michael E DeBakey Veterans Affairs Medical Center

Richard J Ou, MD is a member of the following medical societies: American Academy of Ophthalmology, American Medical Association, Harris County Medical Society, and Texas Medical Association

Disclosure: Nothing to disclose.

Coauthor(s)

Marc O Yoshizumi, MD  Director of Eye Trauma and Emergency Center, Professor, Department of Ophthalmology, Jules Stein Eye Institute, University of California at Los Angeles

Marc O Yoshizumi, MD is a member of the following medical societies: American Academy of Ophthalmology

Disclosure: Nothing to disclose.

Specialty Editor Board

Brian A Phillpotts, MD  Former Vitreo-Retinal Service Director, Former Program Director, Clinical Assistant Professor, Department of Ophthalmology, Howard University College of Medicine

Brian A Phillpotts, MD is a member of the following medical societies: American Academy of Ophthalmology, American Diabetes Association, American Medical Association, and National Medical Association

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Steve Charles, MD  Director of Charles Retina Institute; Clinical Professor, Department of Ophthalmology, University of Tennessee College of Medicine; Adjunct Professor of Ophthalmology, Columbia College of Physicians and Surgeons; Clinical Professor Ophthalmology, Chinese University of Hong Kong

Steve Charles, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Retina Specialists, Club Jules Gonin, Macula Society, and Retina Society

Disclosure: Alcon Laboratories Consulting fee Consulting; OptiMedica Ownership interest Other; Topcon Medical Lasers Consulting fee Consulting

Lance L Brown, OD, MD  Ophthalmologist, Affiliated With Freeman Hospital and St John's Hospital, Regional Eye Center, Joplin, Missouri

Disclosure: Nothing to disclose.

Chief Editor

Hampton Roy Sr, MD  Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, and Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

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Right eye of a 28-year-old female with subarachnoid hemorrhage 1 week after intracranial surgery.
Left eye of a 28-year-old female with subarachnoid hemorrhage 1 week after intracranial surgery.
 
 
 
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