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Cases reported "Horner Syndrome"

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11/32. Purtscher-like retinopathy and Horner's syndrome following coil embolization of an intracavernous carotid artery aneurysm.

    BACKGROUND: Coil embolization is a non-invasive method for treating intracranial vascular malformations by inducing thrombus formation. It is particularly useful in management of cerebral aneurysms and avoids the risks associated with surgical clipping. Occasionally, embolic complications occur which result in transient or permanent loss of vision. methods: Case report of a 29-year-old Caucasian woman who underwent coil embolization and balloon occlusion of an intracavernous carotid aneurysm. Shortly thereafter she described visual changes and a droopy eyelid. RESULTS: Examination revealed pupillary miosis and mild ptosis of the right upper lid. perimetry showed an arcuate scotoma superiorly and an inferonasal step in the right eye. Fundus examination revealed multiple cotton-wool spots along the peripapillary area and along the temporal vascular arcades reminiscent of Purtscher retinopathy. After 4 weeks, she had marked improvement in her visual symptoms. Most of the cotton-wool spots had resolved and the visual field had normalized. However, the ptosis and anisocoria remained unchanged. CONCLUSIONS: Coil embolization is a non-invasive method for treating carotid aneurysms. However, it carries the risk of ophthalmic events, warranting baseline ophthalmic examinations prior to such intervention.
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12/32. Congenital Horner's syndrome: report of one case.

    Congenital Horner's syndrome is an infrequent illness caused by a lesion of the cervical sympathetic nerve fiber. It's clinical features are facial anhidrosis, ptosis, miosis, and hypochromia iridis of the affected side. The subject of this report, a full-term male newborn, had had a smooth birth process but was found on the second day of life to have narrowing of the palpebral fissure and absence of facial flushing on the right side when he cried. Ophthalmologic examination revealed a smaller right pupil. The above abnormalities proved to result from a post-ganglionic lesion, after pharmacologic test. Roentgenograms of the skull, chest and cervical spine were normal, and a computed tomography scan of the cervical spine showed no abnormalities. The diagnosis was of congenital Horner's syndrome. Since no congenital Horner's syndrome to the newborn period could be found in previous literature, this report is presented.
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13/32. Horner's syndrome secondary to tube thoracostomy.

    Tube thoracostomy is a common therapeutic approach applied in medical practice. Certain complications of this procedure have been described in the literature. Oculosympathetic paresis, or Horner's syndrome, occurs from the interruption of second order preganglionic neurons and manifests as miosis, ptosis, hemifacial anhidrosis and enophthalmos. Iatrogenic Horner's syndrome, on the other hand, very rarely couples with tube thoracostomy. Only seven cases have been described in the literature, two of whom were in the pediatric age group. Herein we present a three-year-old girl operated for diaphragmatic hernia who later developed Horner's syndrome at the same side of the thorax tube. Upon the development of the pathology, the tube was repositioned and after one month only a slight ptosis persisted. Our patient seems to be the third case described in the literature. The clinical significance of this pathology is assessed in this report.
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14/32. Iatrogenic Horner's syndrome.

    PURPOSE: To report two cases of Horner's syndrome. One presented after the ablation of a schwannoma of the cervical sympathetic chain, the second after upper thorascopic sympathectomy for primary palmar hyperhidrosis. methods: A 42-year-old man underwent excision of a left neck mass found during routine physical examination. A 20-year-old girl with axillary and palmar hyperhidrosis was treated with cervical sympathectomy. RESULTS: In the early postoperative days, miosis, ptosis, anhidrosis, and enophthalmos were observed. CONCLUSIONS: In the ablation of a schwannoma, postoperative Horner's syndrome is associated with the relationship between nerves and the tumor mass, which makes it impossible to separate them surgically in most cases. In thorascopic sympathectomy, patients should be warned of this complication.
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15/32. Transient partial ophthalmoplegia and Horner's syndrome after intraoral local anesthesia.

    Local neurological symptoms and signs are infrequent after intraoral anesthesia for dental procedures, thus diagnosis may be challenging for a neurologist unfamiliar with this benign phenomenon. Unnecessary diagnostic procedures may be performed and can be associated with complications. We present a 19-year old woman with transient diplopia, miosis, partial enophthalmia and lacrimation on the side of injection after intraoral anesthesia with prilocaine.
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16/32. Review of Horner's syndrome and a case report.

    Sympathetic denervation of the eye [Horner's syndrome (HS)] usually presents as ptosis, miosis, and facial anhydrosis. HS presents a challenge to the clinician because the causative lesion may involve a first, second, or third-order neuron. This paper reviews the literature regarding HS, the anatomy of the sympathetic pathway to the eye, the diagnosis, and the localization of the lesion. Our patient developed reversible HS after a migrainous episode which presumably caused "bruising" of the sympathetic plexus within the carotid canal.
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17/32. "Pneumo-ptosis" in the emergency department.

    The authors report the case of a 16-year-old female who presented with a left tension pneumothorax and a left Horner's syndrome. Chest tube thoracostomy performed to relieve the tension pneumothorax also resulted in the immediate resolution of the patient's ptosis and miosis. The probable mechanism for the patient's focal neurologic signs was traction upon the cervical sympathetic chain secondary to the mediastinal shift of the tension pneumothorax. This case demonstrates that unequal pupils in the presence of a pneumothorax could represent Horner's syndrome.
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18/32. Congenital Horner's syndrome associated with cervical neuroblastoma.

    A 3-month-old girl was presented with a right-sided neck mass present since birth and accompanied by homolateral miosis, ptosis and enophthalmos (Horner's syndrome). Diagnostic work-up revealed an underlying cervical neuroblastoma. Although the association of Horner's syndrome with acquired neuroblastoma is well-known and of value in early diagnosing of such a tumor, it can also be a presenting or accompanying sign in rare cases of congenital neuroblastoma.
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19/32. Congenital Horner's syndrome and the usefulness of the apraclonidine test in its diagnosis.

    We present a seven-month-old baby with miosis of the left pupil, left hypochromia, mild ipsilateral ptosis, left hemifacial anhidrosis and asymmetrical facial flushing. A diagnosis of Horner's syndrome (HS) was presumed and was confirmed by instillation of apraclonidine eye drops. miosis was reversed upon apraclonidine instillation. magnetic resonance imaging of the head, neck and thorax and ultrasonography of the neck and abdomen did not reveal any pathological conditions. Although delivery-related brachial plexus injury is known as the most common cause of congenital HS, it should be investigated and should include neuroimaging of the sympathetic pathway, to exclude a serious underlying disease. As in our case, a specific etiology may not always be elicited. Pharmacological testing with apraclonidine may be a practical alternative to cocaine in the diagnosis of HS.
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20/32. Contralateral trochlear nerve paresis and ipsilateral Horner's syndrome.

    Two patients had paresis of the trochlear nerve contralateral to the site of lesions in the brainstem. Both patients had ipsilateral blepharoptosis and miosis suggesting oculosympathetic paresis from involvement of the descending sympathetic tract, adjacent to the fourth cranial nerve nucleus and its fascicles, in the caudal mesencephalon. Cerebral antiography documented an arteriovenous malformation of the brainstem in Case 1. magnetic resonance imaging disclosed a lesion of high signal intensity on T2-weighted images involving the dorsal mesencephalon in Case 2. Involvement of the superior cerebellar peduncle produced ipsilateral dysmetria and ataxia. Lesions involving the fourth cranial nerve nucleus or its fascicles, before decussation in the superior medullary velum, and adjacent sympathetic fibers may produce an ipsilateral Horner's syndrome and contralateral superior oblique muscle paresis.
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Last update: April 2009
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