Abstracts/Presentation Description
Chris O'Donnell1
1VIFM
Purpose: To provide an overview of Terson syndrome, ability of PMCT to detect retinal haemorrhage and its relevance in medicolegal death investigation.
Discussion: Originally described in 1881 and popularised by Terson in 1900, this clinical syndrome is characterised by retinal haemorrhage in the context of spontaneous subarachnoid haemorrhage (SAH). It was once conjectured that subarachnoid blood passed through the optic nerve sheath into the retina, but anatomical studies have shown that the arachnoid ends at the sclera. It is now thought that acute raised intracranial pressure associated with SAH leads to retinal venous obstruction, resultant venous ischaemia and subsequent haemorrhage. This is confirmed on clinical fluorescein angiography. Retinal haemorrhage can be detected on PMCT as a crescent of high Hounsfield unit density and in our series of 456 fatal non-traumatic SAH cases, was detected in 20 (4.4%).
Conclusion: Retinal haemorrhage following spontaneous SAH (Terson syndrome) can be detected on PMCT, and its significance is important for forensic pathologists to understand, as it is not necessarily a portent of preceding head trauma.
1VIFM
Purpose: To provide an overview of Terson syndrome, ability of PMCT to detect retinal haemorrhage and its relevance in medicolegal death investigation.
Discussion: Originally described in 1881 and popularised by Terson in 1900, this clinical syndrome is characterised by retinal haemorrhage in the context of spontaneous subarachnoid haemorrhage (SAH). It was once conjectured that subarachnoid blood passed through the optic nerve sheath into the retina, but anatomical studies have shown that the arachnoid ends at the sclera. It is now thought that acute raised intracranial pressure associated with SAH leads to retinal venous obstruction, resultant venous ischaemia and subsequent haemorrhage. This is confirmed on clinical fluorescein angiography. Retinal haemorrhage can be detected on PMCT as a crescent of high Hounsfield unit density and in our series of 456 fatal non-traumatic SAH cases, was detected in 20 (4.4%).
Conclusion: Retinal haemorrhage following spontaneous SAH (Terson syndrome) can be detected on PMCT, and its significance is important for forensic pathologists to understand, as it is not necessarily a portent of preceding head trauma.
Speaker/Presenting Authors
Authors
Submitting/Presenting Authors
Dr Chris O'Donnell Dr. - VIFM (Victoria, Australia)