Wednesday, June 13, 2012

What Do You See?

Hello! Again, I apologize for the delay in cases; things have been awfully busy and I simply didn't have time to write. Here's a case I saw this week though, and I think the next case will probably be next Monday.

Thanks for understanding, and I appreciate your following along,

A 55 year old hypertensive smoker presents with an abrupt onset 10/10 headache, confusion, and vomiting. His main concern, however, is his vision; he has trouble seeing. A dilated eye exam is shown above. Panel A shows the right fundus, panel B the left fundus, panel C a week after laser treatment, and panel D two weeks after treatment. A non-contrast CT head from the ED is shown below.

Challenge: What diagnosis and syndrome are described here?

First image shown under Fair Use; second image shown under Creative Commons Attribution Share-Alike License.


Anonymous said...

SAH with Terson's syndrome? Great case!

Craig Chen said...

yes! i saw this recently, learned all about it from ophthalmology consultants
What Do You See?

Terson syndrome is the association between subarachnoid hemorrhage (seen in the second image) with retinal subhyaloid hemorrhages and vitreous hemorrhages (first image). The presence of Terson syndrome implies a poorer prognosis.

Sources: UpToDate;; Wikipedia.