Incidence of Terson's syndrome in patients with SAH in a Chinese hospital.

PURPOSE: To investigate the incidence and relative factors of Terson's syndrome (TS) in patients with subarachnoid hemorrhage (SAH) in China.

MATERIALS AND METHODS: A case series study was conducted from November 2009 to June 2010 on 155 patients (310 eyes) with aneurysmal and traumatic SAH. A thorough, direct funduscopic examination was performed on all participants and the incidence of TS analyzed. Associations between TS and gender, state-of-consciousness, Glasgow Coma Scale (GCS) score, Hunt-Hess grade, anatomical location of ruptured aneurysms, and mortality rates were analyzed.

RESULTS: TS was diagnosed in 20 of 155 SAH patients (30 eyes), and detected in 16 (14.16%) of 113 patients with aneurysmal SAH and four (9.52%) of 42 patients with traumatic SAH. No correlations were found between state-of-consciousness, GCS scores, and presence of TS in patients with traumatic SAH. Among patients suffering from aneurysmal SAH, however, significant relationships were observed between state-of-consciousness, GCS scores, Hunt-Hess grades, and incidence of TS (p < 0.01). No statistically significant difference was observed between men and women with regard to the incidence of TS (χ(2) = 0.821, p = 0.365). Furthermore, no correlation was found between location of ruptured aneurysms (p = 1.000), mortality rates (p = 0.146), and incidence of TS.

CONCLUSIONS: Compared with traumatic SAH, a higher incidence of TS was observed in patients with aneurysmal SAH, a condition significantly associated with a person's overall condition. Therefore, aneurysmal SAH patients with consciousness-disturbance, lower GCS scores, and higher Hunt-Hess grades should be paid particular attention by ophthalmologists when performing fundus examinations. The question of whether SAH with TS is prognostic of spontaneous SAH is an area in need of further study.