Título / Title

MEDICAL INTERDISCIPLINARITY: WHEN AN OPHTHALMOLOGICAL DIAGNOSIS CAN CHANGE THE PROGNOSTIC OF LIFE.

Introdução / Purpose

The first report of intraocular hemorrhage secondary to subarachnoid hemorrhage was performed in 1881 by Dr. Litten. Such a condition in 1900 was given the name Terson's syndrome after Dr. Terson described vitreous hemorrhages associated with intracranial hemorrhages. The following report aims to describe the importance of early diagnosis of intraretinal and intravitreal hemorrhages secondary to intracranial aneurysms.

Material e Método / Methods

Man, 56 years old, admitted to the emergency room of the UNICAMP ophthalmology with a history of headache for 5 days, followed by a fall of his own height. It evolved with gradual low vision in the left eye two days after the onset of the condition. He had systemic arterial hypertension, type 2 diabetes mellitus and treated intraventricular communication. He denied any associated ocular pathology. At the examination: Visual acuity (VA) with refractive correction (20:25 and 20:800), biomicroscopy of both eyes (not worthy of note), fundoscopy (right eye: posterior pole microaneurysms, left eye: subhyaloid hemorrhage and subretinal hemorrhages scattered posteriorly).

Resultados / Results

After the hypothesis of Terson's syndrome was considered, the patient was referred to the emergency department of UNICAMP, where a ruptured aneurysm of the anterior communicating cerebral artery was detected after a skull angiotomography, and the aneurysm was subsequently clipped. After 5 months of expectant management, there was complete reabsorption of retinal hemorrhages and, on examination, had corrected VA (20:25 and 20:30).

Discussão e Conclusões / Conclusion

This case reveals the importance of remembering the relationship between intracranial hemorrhages as a cause of intraocular bleeding in patients with associated ophthalmologic symptoms, signs of neurological involvement, such as headache. The fast interaction of ophthalmology and neurosurgery may change the prognosis of life of these patients.

Palavras Chave

Intracranial aneurysms, Terson's syndrome, Medical interdisciplinarity