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萌妹子给大汉来电：“大汉，有个朋友和人家掰腕子，结果玻璃体出血了，你在门诊给他开个CT吧。”大汉一脸懵逼，玻璃体出血，看眼科啊，开头CT干嘛？虽然不愿意，还是开了，结果出来大汉傻眼了，蛛网膜下腔出血。萌妹子告诉大汉，你ZAO吗，有一种玻璃体出血是SAH导致的，也叫terson综合征。她儿子综合征？大汉更加懵逼，突然觉得自己像个白痴，赶紧看书…… Terson syndrome or Terson's syndromeis the occurrence of a vitreous hemorrhage of the human eye in association withsubarachnoid hemorrhage. Vitreous hemorrhage of the eye can also occur inassociation with intracranial hemorrhage and elevated intracranial pressure(ICP). Intraocular hemorrhage can be a subretinal, retinal, preretinal,subhyaloidal, or intra-vitreal hemorrhage. Its likely cause is a rapid increasein ICP. The classic presentation is in the subhyaloidal space, which is beneaththe posterior vitreous face and in front of the retina. In subarachnoid hemorrhage, 13% of patients have Terson'ssyndrome, which is associated with more severe SAH (higher Hunt-Hess score, amarker of severity), and risk of death is significantly increased. The first known report of the association was by the Germanophthalmologist Moritz Litten in 1881. Still, French ophthalmologist AlbertTerson's name is more commonly associated with the condition after a report byhis hand from 1900. 1900年Terson首先报道了颅内出血可以是玻璃体出血的原因，并且认为是蛛网膜下腔出血的征象，称为Terson综合征。Terson综合征为眼内出血合并任何形式的颅内出血伴急剧颅内压升高。Terson综合征发生机制不明。有人认为是颅内压升高使得蛛网膜下腔的出血通过筛板进入眼内。但一般认为可能是颅内压的突然升高，压力传递到视网膜血管使视网膜静脉的破裂而出血，导致内界膜与视网膜的劈裂分离。如出血量不多，血液积存于视网膜层间，但出血量大时可以造成内界膜的撕裂，积血大量涌入玻璃体内。13%蛛网膜下腔出血可出现Terson综合征，与蛛网膜下腔出血的严重程度相关（Hunt Hess评分较高，被认为是严重程度的一个标志），其死亡的风险显著增加。Terson综合征患者中有玻璃体出血的其死亡率为53.6%，而无玻璃体出血的其死亡率只有19.7%。颅内出血的患者如能存活，视网膜和视网膜前膜的出血一般能吸收而不留明显后遗症，但也有部分造成永久的视力损害。 大汉在网上一查发现，倒立，掰腕子这些运动都可以导致terson综合征，顿时觉得生活中处处也是坑，上上次是坐过山车导致了卒中，上次是仰卧起坐导致了脊髓半切综合征，这次是掰腕子导致脑出血，下次呢？ |
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