Transient bilateral striatal lesion associated with varicella infection

1. Hospital Universitário Cassiano Antônio Morais da Universidade Federal do Espírito Santo (HUCAM-UFES), Vitória, ES, Brazil. Mailing address: Dra. Ana Paula Alves Fonseca. Rua Major Clarindo Fundão, 110, ap. 604, Praia do Canto. Vitória, ES, Brazil, 29055-655. E-mail: [email protected]. rapid increase in venous or intracranial pressure, which causes rupture of the peripapillary capillaries of the retina or results in compression of the central retinal vein, thus decreasing retinal venous drainage, promoting stasis, and provoking hemorrhage. The diagnosis of intraocular hemorrhage is more accurately confirmed by ophthalmoscopy, although CT can suggest it, with an estimated sensitivity of 66%. The changes seen most frequently are retinal thickening and hyperattenuating nodules overlying the optic disc. Terson’s syndrome most often occurs in patients with severe neurological disease, a Glasgow Coma Scale ≤ 8, and aneurysmal subarachnoid hemorrhage with a Fisher score ≥ 3 at presentation. It is also of note that the rates of morbidity and mortality are high among such patients. In the sample studied by Fountas et al., the mortality was 28.6% among the patients with intraocular hemorrhage, compared with only 2.0% among those without. Terson’s syndrome is not an uncommon condition, perhaps being underdiagnosed. Given the prognostic implications of this diagnosis for morbidity and mortality, as well as the potential for secondary ocular lesion, it is of extreme relevance to radiologists and other medical professionals, especially in the context of acute subarachnoid hemorrhage but also in other forms of intracranial hemorrhage. REFERENCES