1/4. Horner's syndrome resulting from agenesis of the internal carotid artery: report of a third case.INTRODUCTION: Only two previous reports of agenesis of the internal carotid artery with a coexistent Horner's syndrome are to be found in the medical literature. CASE REPORT: We report a case of a male child seen initially for what was presumed to be a traumatic superficial temporal artery aneurysm. MRA incidentally revealed ipsilateral agenesis of the internal carotid artery. This child's physical exam included ipsilateral Horner's syndrome. CONCLUSION: This case report illustrates that agenesis of the internal carotid artery does indeed cause Horner's syndrome in some cases. The clinician who diagnoses a patient with Horner's syndrome should remember that agenesis of the internal carotid artery may be the cause as this entity can be associated in itself with other pathologies of the central nervous system.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/4. Postpartum unilateral Horner's syndrome following lumbar epidural anesthesia after a Cesarean delivery.We report on a case demonstrating unilateral Horner's syndrome (HS) after lumbar epidural obstetric anesthesia. A healthy, 32-year-old woman with a breech presentation was scheduled for an elective cesarean section. The patient had normal vital signs throughout the surgical procedure. The operation lasted for 50 min. In the recovery room, she complained of left nasal stuffiness, left cheek numbness, and heaviness in her left eye. Meanwhile, left nipple sensory loss was noted during baby suckling training. On physical examination, her left eyelid was droopy along with left-side ptosis and facial flushing. Reduced sensation over the left hemifacial region and upper arm was also noted, which resolved completely over the next 110 min. A diagnosis of unilateral HS was then made. Although typically a benign side effect which often spontaneously resolves, HS is likely to cause anxiety in both the patient and the doctor. Prompt recognition of this syndrome and determination of its cause from lumbar epidural anesthesia can prevent unnecessary and potentially dangerous diagnostic workup and can reassure both patients and clinicians. The patient was discharged from the hospital 5 days after onset with a good outcome.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/4. 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.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
4/4. Horner's syndrome in the emergency department.We present a case of a 47-year-old female who was followed for 7 months with complaints of musculoskeletal pain involving the shoulder and scapula until she presented to the emergency department with Horner's syndrome and was diagnosed as having a superior pulmonary sulcus tumor. A review of the literature shows that although such tumors are a frequent cause of Horner's syndrome there are numerous other benign as well as malignant causes of Horner's syndrome. The differential diagnosis can be significantly narrowed by a knowledge of the anatomy and a careful physical examination. We present the anatomy, pathophysiology, differential diagnosis, and evaluation of patients who present to the emergency department with Horner's syndrome.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |