UMEM Educational Pearls

Category: Neurology

Title: What is the cause of this patient's decreased vision?

Keywords: Terson syndrome, vitreous hemorrhage, intraocular hemorrhage, subarachnoid hemorrhage (PubMed Search)

Posted: 7/12/2017 by WanTsu Wendy Chang, MD
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50 YOF with acute onset of worst headache of life associated with nausea and vomiting.  Patient is somnolent, will rouse to noxious stimuli and complains of a headache as well as decreased vision.


  • There is a vitreous hemorrhage of the left globe associated with subarachnoid hemorrhage (SAH), intraventricular hemorrhage, and diffuse cerebral edema on this non-contrast head CT.
  • This is also known as Terson syndrome, reported to occur in 15-30% of patients with SAH.
  • The mechanism by which this intraocular hemorrhage occurred is thought to be from a sudden increase in intracranial pressure causing obstruction of the central retinal vein.


Image courtesy of Dr. Nasir Siddiqui, From the case rID: 36469


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