A Case of Terson-Like Syndrome in a Patient with Viral Meningoencephalitis

The proposed mechanism of Terson’s syndrome is increased intracranial pressure that leads to dilation of the retrobulbar optic nerve and compression of the central retinal vein. Terson’s syndrome has been associated with many conditions that increase intracranial pressure such as venous sinus thromb...

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Bibliographic Details
Published in:Case reports in ophthalmological medicine 2019-01, Vol.2019 (2019), p.1-5
Main Authors: Malik, Deepika, Peddada, Krishi, Weiss, Stephanie J., Asahi, Masumi G.
Format: Article
Language:English
Subjects:
Blood clot
Case Report
Case reports
Edema
Encephalitis
Head injuries
Hemorrhage
Hospitals
Infections
Inflammation
Leukemia
Medical imaging
Meningitis
Meningoencephalitis
Neurology
Neurosurgery
Ophthalmology
Optic nerve
Patients
Pediatrics
Shaken baby syndrome
Syphilis
Thrombosis
Viral infections
Viruses
West Nile virus
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Summary:The proposed mechanism of Terson’s syndrome is increased intracranial pressure that leads to dilation of the retrobulbar optic nerve and compression of the central retinal vein. Terson’s syndrome has been associated with many conditions that increase intracranial pressure such as venous sinus thrombosis, Moyamoya disease, leukemia, direct head trauma, and intraocular hemorrhage related to shaken baby syndrome. We present a novel case of a patient with recent viral prodrome found to have papilledema and multilayered retinal hemorrhages consistent with Terson syndrome. Computed tomography and magnetic resonance venography of the brain did not reveal any subdural, subarachnoid, or intracranial hemorrhages. However, cerebrospinal fluid analyses were significant for increased opening pressure and elevated protein levels, which were suggestive of viral meningoencephalitis. We describe this case as a Terson-like syndrome because the etiology of intraocular hemorrhage is increased intracranial pressure. However, this case does not fit the traditional presentation of Terson’s syndrome as the intracranial pressure is secondary to meningeal inflammation instead of subdural, subarachnoid, or intracranial hemorrhage. We strongly feel that it is important for physicians to be aware of the link between viral meningoencephalitis and retinal conditions such as Terson-like syndrome because it can facilitate rapid diagnosis and treatment.
ISSN:2090-6722
2090-6730
DOI:10.1155/2019/9650675