Frequency of Ocular Hemorrhages in Patients with Subarachnoid Hemorrhage
Neß T.1, Janknecht P.2, Berghorn C.1
1Universitäts-Augenklinik Freiburg; 2Praxisklinik Wangen
Purpose: Vitreous hemorrhage (Terson´s syndrome) and other intraocular hemorrhages have been reported in up to 40% of patients with subarachnoidal hemorrhage (SAH). Our objective was to determine prospectively the frequency of ocular involvement and the relationship to the grade of SAH.
Method: Seventy-three consecutive patients with SAH were propectively examined.The patients were classified by Hunt and Hess grade and ophthalmological examination was performed by an ophthalmologist.
Results: SAH was caused in all patients by a ruptured cerebral aneurysm. In 27% of the patients intraocular hemorrhages were present. All had retinal hemorrhages, which were detectable unilateral in 45%. In 15% typical retrohyaloidal or vitreal hemorrhages were present. Ocular involvement was statistically more frequent in patients with higher grade of SAH classified by Hunt-Hess.
Conclusions: Due to ocular involvement in more than 25% of the patients with SAH and due to the fact that ocular involvement is related to the severity of SAH, screening of all patients with SAH is recommendable. This patients were so disabled, that they not complained symptoms by theirself. Early vitrectomy of vitreous hemorrhages provides more effective rehabiltation.
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