泰森综合征：意识障碍患者中不容忽视的病症。

Terson Syndrome: Not to Be Missed in Patients with Disorders of Consciousness.

作者信息

Maslias Errikos, Vijiala Sergiu, Epiney Jean-Benoit, Konstantinidis Lazaros, Kawasaki Aki, Diserens Karin

机构信息

Unit of Acute Neurorehabilitation, Department of Clinical Neurosciences, Service of Neurology, Lausanne University Hospital (CHUV), University of Lausanne, 1011 Lausanne, Switzerland.

Stroke Center and Department of Clinical Neurosciences, Service of Neurology, Lausanne University Hospital (CHUV), University of Lausanne, 1011 Lausanne, Switzerland.

出版信息

Brain Sci. 2023 May 29;13(6):879. doi: 10.3390/brainsci13060879.

DOI:10.3390/brainsci13060879

PMID:37371359

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10296622/

Abstract

The diagnosis of clinical cognitive motor dissociation (CMD) can be hindered by pitfalls during standardized clinical evaluation based on gold-standard neurobehavioral rating scales. We introduce here a new pitfall, by reporting two cases of Terson syndrome (TS) after subarachnoid haemorrhage (SAH) caused by the rupture of an anterior communicant artery aneurysm, hospitalized in the Acute Neurorehabilitation Unit (ANR) of CHUV. TS is reported to occur in 8-19.3% of patients suffering from SAH. It can lead to significant visual impairment and if unrecognized, may impair the patient's capacity to interact appropriately with the environment; it thus presents an important pitfall in recognizing clinical cognitive-motor dissociation (CMD) in patients with altered states of consciousness. An early ophthalmological exam should be considered in all patients with SAH and disorders of consciousness or visual complaints.

摘要

基于金标准神经行为评定量表的标准化临床评估过程中存在的陷阱可能会妨碍临床认知运动分离（CMD）的诊断。我们在此报告两例因前交通动脉动脉瘤破裂导致蛛网膜下腔出血（SAH）后出现Terson综合征（TS）的病例，这两位患者均在CHUV的急性神经康复科（ANR）住院，借此介绍一种新的陷阱情况。据报道，TS在8%-19.3%的SAH患者中出现。它可导致严重的视力损害，如果未被识别，可能会损害患者与环境进行适当互动的能力；因此，它是识别意识状态改变患者临床认知运动分离（CMD）时的一个重要陷阱。所有SAH患者以及有意识障碍或视觉主诉的患者均应考虑早期眼科检查。