MRIで興味深い所見を呈したTerson症候群の1例

A Case of Terson's Syndrome with an Interesting MRI Finding

I．はじめに

　くも膜下出血に伴う硝子体出血によって視野障害をきたす疾患が1900年Tersonにより初めて報告された^17）．以後，その発生機序や治療，予後等についてさまざまな報告がなされたが，診断は眼底写真によるところが大きく，CTやMRIによる評価をしたものは少ない．今回，くも膜下出血患者のMRIにてTerson症候群に特異的と思われる所見を認めたので，若干の文献的考察を加え報告する．

We report a case of a 62-year-old woman admitted to our hospital in a semicomatose state. CT scan and MRI on admission revealed a dense subarachnoid hemorrhage and intracerebral hematoma in the right frontal lobe. Digital subtraction angiography showed a saccular aneurysm located in the anterior communi-cating artery, so radical neck clipping of the aneurysm was performed via the right pterional approach. The operation was unevential.

The patient complained of bilateral visual disturbance on the next day and FLAIR image of MRI de-monstrated clearly crescent shaped and mobile high intense lesions corresponding to subhyaloid vitreous hemorrhage in both eye balls. The fundoscopic examination revealed an intravitreous hemorrhage which gradually disappeared over the next 12 days.

Terson's syndrome after subarachnoid hemorrhage has been linked to an entity of poor prognosis, so it is beneficial that characteristic findings in FLAIR image of MRI can lead to correct diagnosis of Terson's syndrome earlier.