Question

50 YOF with acute onset of worst headache of life associated with nausea and vomiting.  Patient is somnolent, will rouse to noxious stimuli and complains of a headache as well as decreased vision.

Answer

• There is a vitreous hemorrhage of the left globe associated with subarachnoid hemorrhage (SAH), intraventricular hemorrhage, and diffuse cerebral edema on this non-contrast head CT.
• This is also known as Terson syndrome, reported to occur in 15-30% of patients with SAH.
• The mechanism by which this intraocular hemorrhage occurred is thought to be from a sudden increase in intracranial pressure causing obstruction of the central retinal vein.

References

Image courtesy of Dr. Nasir Siddiqui, Radiopaedia.org. From the case rID: 36469

 

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