دورية أكاديمية
An explanation for Terson syndrome at last: the glymphatic reflux theory.
العنوان: | An explanation for Terson syndrome at last: the glymphatic reflux theory. |
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المؤلفون: | Kumaria A; Department of Neurosurgery, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, NG7 2UH, UK. Ashwin.Kumaria@doctors.org.uk., Gruener AM; School of Medicine, University of Nottingham, Nottingham, UK.; Department of Ophthalmology, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK., Dow GR; Department of Neurosurgery, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, NG7 2UH, UK., Smith SJ; Department of Neurosurgery, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, NG7 2UH, UK.; School of Medicine, University of Nottingham, Nottingham, UK., Macarthur DC; Department of Neurosurgery, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, NG7 2UH, UK.; School of Medicine, University of Nottingham, Nottingham, UK., Ingale HA; Department of Neurosurgery, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, NG7 2UH, UK. |
المصدر: | Journal of neurology [J Neurol] 2022 Mar; Vol. 269 (3), pp. 1264-1271. Date of Electronic Publication: 2021 Jun 25. |
نوع المنشور: | Journal Article; Review |
اللغة: | English |
بيانات الدورية: | Publisher: Springer-Verlag Country of Publication: Germany NLM ID: 0423161 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-1459 (Electronic) Linking ISSN: 03405354 NLM ISO Abbreviation: J Neurol Subsets: MEDLINE |
أسماء مطبوعة: | Original Publication: Berlin ; New York, Springer-Verlag |
مواضيع طبية MeSH: | Intracranial Hypertension*/etiology , Subarachnoid Hemorrhage*/complications, Humans ; Intracranial Pressure ; Optic Nerve/diagnostic imaging ; Vitreous Hemorrhage/etiology |
مستخلص: | Terson Syndrome (TS) describes the presence of intraocular hemorrhage in patients with intracranial hemorrhage, typically subarachnoid hemorrhage. Despite TS being a well-defined and frequently occurring phenomenon, its pathophysiology remains controversial. This review will present the current understanding of TS, with view to describing a contemporary and more plausible pathomechanism of TS, given recent advances in ophthalmic science and neurobiology. Previously proposed theories include a sudden rise in intracranial pressure (ICP) transmitted to the optic nerve sheath leading to rupture of retinal vessels; or intracranial blood extending to the orbit via the optic nerve sheath. The origin of blood in TS is uncertain, but retinal vessels appear to be an unlikely source. In addition, an anatomical pathway for blood to enter the eye from the intracranial space remains poorly defined. An ocular glymphatic system has recently been described, drainage of which from the globe into intracranial glymphatics is reliant on the pressure gradient between intraocular pressure and intracranial pressure. The glymphatic pathway is the only extravascular anatomical conduit between the subarachnoid space and the retina. We propose that subarachnoid blood in skull base cisterns near the optic nerve is the substrate of blood in TS. Raised ICP causes it to be refluxed through glymphatic channels into the globe, resulting in intraocular hemorrhage. We herewith present glymphatic reflux as an alternative theory to explain the phenomenon of Terson Syndrome. (© 2021. Springer-Verlag GmbH Germany, part of Springer Nature.) |
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فهرسة مساهمة: | Keywords: Glymphatic system; Intraocular hemorrhage; Subarachnoid hemorrhage; Terson syndrome |
تواريخ الأحداث: | Date Created: 20210625 Date Completed: 20220222 Latest Revision: 20220222 |
رمز التحديث: | 20231215 |
DOI: | 10.1007/s00415-021-10686-4 |
PMID: | 34170402 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1432-1459 |
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DOI: | 10.1007/s00415-021-10686-4 |