Terson’s Syndrome with Roth Spot-Resembling Features and Third Nerve Palsy without Radiologically Diagnosed Subarachnoid Haemorrhage
We report an unusual case of pupil-involving third nerve palsy associated with Terson’s syndrome that resulted in the diagnosis of a right posterior communicating artery aneurysm. Interestingly, Terson’s syndrome presented with Roth spot-resembling features, accompanied by third nerve palsy in a pat...
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2024-10-01
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| author | Olga E. Makri Iasonas K. Tsekouras Stylianos N. Mastronikolis Vasileios E. Panagiotopoulos Constantine Constantoyannis Constantinos D. Georgakopoulos |
| author_facet | Olga E. Makri Iasonas K. Tsekouras Stylianos N. Mastronikolis Vasileios E. Panagiotopoulos Constantine Constantoyannis Constantinos D. Georgakopoulos |
| author_sort | Olga E. Makri |
| collection | DOAJ |
| description | We report an unusual case of pupil-involving third nerve palsy associated with Terson’s syndrome that resulted in the diagnosis of a right posterior communicating artery aneurysm. Interestingly, Terson’s syndrome presented with Roth spot-resembling features, accompanied by third nerve palsy in a patient without any disturbance of consciousness. To our knowledge, the association of Terson’s syndrome with third nerve palsy has not been described before in the absence of radiologically diagnosed subarachnoid haemorrhage. We present the case of a 48-year-old woman who presented in the Department of Emergencies of the University Hospital of Patras with right-sided complete-pupil-involving third nerve palsy combined with bilateral Terson’s syndrome. More precisely, fundoscopy revealed multiple scattered intra- and pre-retinal haemorrhages in both eyes, while some retinal haemorrhages had a white-centred pattern resembling Roth spots. Neurological examination revealed no nuchal rigidity or any other neurological signs. The Glasgow coma scale score was 15/15. A cerebral computed tomography angiography revealed a 5 mm aneurysm of the right posterior communicating artery and the patient underwent a microvascular clipping operation after craniotomy. The significant contribution of the ophthalmological consultation to the appropriate and timely diagnosis and management of a life-threatening condition is highlighted. |
| format | Article |
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| institution | DOAJ |
| issn | 2411-5150 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | MDPI AG |
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| spelling | doaj-art-dafd40e0700446e28735a47ebd1555162025-08-20T02:56:55ZengMDPI AGVision2411-51502024-10-01846110.3390/vision8040061Terson’s Syndrome with Roth Spot-Resembling Features and Third Nerve Palsy without Radiologically Diagnosed Subarachnoid HaemorrhageOlga E. Makri0Iasonas K. Tsekouras1Stylianos N. Mastronikolis2Vasileios E. Panagiotopoulos3Constantine Constantoyannis4Constantinos D. Georgakopoulos5Department of Ophthalmology, Medical School, University of Patras, 26504 Patras, GreeceDepartment of Ophthalmology, Medical School, University of Patras, 26504 Patras, GreeceDepartment of Ophthalmology, Medical School, University of Patras, 26504 Patras, GreeceDepartment of Neurosurgery, Medical School, University of Patras, 26504 Patras, GreeceDepartment of Neurosurgery, Medical School, University of Patras, 26504 Patras, GreeceDepartment of Ophthalmology, Medical School, University of Patras, 26504 Patras, GreeceWe report an unusual case of pupil-involving third nerve palsy associated with Terson’s syndrome that resulted in the diagnosis of a right posterior communicating artery aneurysm. Interestingly, Terson’s syndrome presented with Roth spot-resembling features, accompanied by third nerve palsy in a patient without any disturbance of consciousness. To our knowledge, the association of Terson’s syndrome with third nerve palsy has not been described before in the absence of radiologically diagnosed subarachnoid haemorrhage. We present the case of a 48-year-old woman who presented in the Department of Emergencies of the University Hospital of Patras with right-sided complete-pupil-involving third nerve palsy combined with bilateral Terson’s syndrome. More precisely, fundoscopy revealed multiple scattered intra- and pre-retinal haemorrhages in both eyes, while some retinal haemorrhages had a white-centred pattern resembling Roth spots. Neurological examination revealed no nuchal rigidity or any other neurological signs. The Glasgow coma scale score was 15/15. A cerebral computed tomography angiography revealed a 5 mm aneurysm of the right posterior communicating artery and the patient underwent a microvascular clipping operation after craniotomy. The significant contribution of the ophthalmological consultation to the appropriate and timely diagnosis and management of a life-threatening condition is highlighted.https://www.mdpi.com/2411-5150/8/4/61Terson’s syndromeRoth spotsthird nerve palsyposterior communicating artery aneurysm |
| spellingShingle | Olga E. Makri Iasonas K. Tsekouras Stylianos N. Mastronikolis Vasileios E. Panagiotopoulos Constantine Constantoyannis Constantinos D. Georgakopoulos Terson’s Syndrome with Roth Spot-Resembling Features and Third Nerve Palsy without Radiologically Diagnosed Subarachnoid Haemorrhage Vision Terson’s syndrome Roth spots third nerve palsy posterior communicating artery aneurysm |
| title | Terson’s Syndrome with Roth Spot-Resembling Features and Third Nerve Palsy without Radiologically Diagnosed Subarachnoid Haemorrhage |
| title_full | Terson’s Syndrome with Roth Spot-Resembling Features and Third Nerve Palsy without Radiologically Diagnosed Subarachnoid Haemorrhage |
| title_fullStr | Terson’s Syndrome with Roth Spot-Resembling Features and Third Nerve Palsy without Radiologically Diagnosed Subarachnoid Haemorrhage |
| title_full_unstemmed | Terson’s Syndrome with Roth Spot-Resembling Features and Third Nerve Palsy without Radiologically Diagnosed Subarachnoid Haemorrhage |
| title_short | Terson’s Syndrome with Roth Spot-Resembling Features and Third Nerve Palsy without Radiologically Diagnosed Subarachnoid Haemorrhage |
| title_sort | terson s syndrome with roth spot resembling features and third nerve palsy without radiologically diagnosed subarachnoid haemorrhage |
| topic | Terson’s syndrome Roth spots third nerve palsy posterior communicating artery aneurysm |
| url | https://www.mdpi.com/2411-5150/8/4/61 |
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