Terson’s syndrome in spontaneous spinal subarachnoid haemorrhage

This paper is a case report of Terson’s Syndrome (TS) in spontaneous spinal subarachnoid haemorrhage (SAH). A 66-year-old woman with acute onset of severe back pain was transferred to our institution for management of her sciatica. The presence of an intraretinal haemorrhage alerted us to consider intracranial SAH, but investigations showed no intracranial source. Eventually, the patient was diagnosed with a thoracic spinal SAH. The patient’s symptoms gradually improved with conservative management but within 1 month she had a recurrence. A spinal and CT angiogram did not elicit the aetiology. The diagnosis of spontaneous spinal SAH can be difficult. The recognition of TS has important prognostic implications, often heralding subarachnoid rebleeding. Fundoscopic examination appears mandatory as a tool for diagnosis and regular non-invasive monitoring of patients with SAH.