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Results for “HORNER SYNDROME”

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PubMed1995

[Horner syndrome due to mediastinal neurinoma--a case report].

Horner syndrome due to mediastinal neurinoma has been reported rare cases so far. We experienced a 55-year-old woman who developed Hornor syndrome due to mediastinal neurinoma and the patient received operation with no major complication. She was admitted to our hospital because of the left shoulder pain and the dilatation of the mediastinum on chest X-ray. She was found to have the left mild ptosis and CT scan showed left upper mediastinal tumor (12 cm in diameter) with tracheal compression. Aortography showed a 8.6 cm tumor stein and lower deviation of aortic arch. The feeding artery was branch of thyrocervical artery. Mediastinal neurinema was found by biopsy. During the operation, we found the origin was the left sympathetic nerve. The post operative course was uneventful however horner syndrome was progressed due to radical resection of the tumor.

Disease Progression↗
PubMed1999

Neurotrophic corneal endothelial failure complicating acute Horner syndrome.

PURPOSE: The authors report the clinical findings of a unique case of rapid corneal endothelial decompensation in association with acute Horner syndrome. STUDY DESIGN: Case report and literature review. METHODS: The authors followed a 38-year-old woman who developed Horner syndrome after right jugular vein catheterization during cardiac valvular surgery. Shortly after the operation, Horner syndrome accompanied by conjunctival hyperemia and stromal corneal edema developed in the right eye. Over the course of 4 months, the eye became painful, the corneal endothelial cell count dropped precipitously, and the stromal edema worsened, causing a difference of 100 microm in central corneal thickness compared to the unaffected eye. Deep stromal vascularization started at the limbus, resembling interstitial keratitis. RESULTS: A 3-week course of topical steroid treatment resulted in a dramatic improvement in the stromal corneal edema and regression of the deep stromal vascularization. Ocular and right hemicranial pain subsided shortly thereafter. CONCLUSION: The authors hypothesize that corneal endothelial failure in this unique case may have resulted from traumatic sympathectomy. According to experimental evidence in the reviewed ophthalmologic literature, sympathetic innervation may have a neurotrophic role in the cornea. Corneal pathology similar to the authors' case has been described in hemifacial atrophy (Parry-Robson syndrome), a disorder that is assumed to result from sympathetic denervation and that can be produced in animals by cervical sympathectomy. The authors therefore hypothesize that sympathetic denervation of the cornea may rarely cause endothelial decompensation and corneal edema. To the authors' knowledge, this is the first reported case of corneal endothelial failure in Horner syndrome.

Acute Disease↗
PubMed1998

[Painful Claude Bernard Horner syndrome: apropos of a painless carotid artery dissection].

We report a case of post-traumatic carotid artery dissection revealed by a painless Horner's syndrome. Horner's syndrome is a neurologic emergency when it appears rapidly, spontaneously or after a trauma. Each painful Horner's syndrome must be considered as due to a homonymous carotid artery dissection until proven otherwise. One must be attentive especially because the pain may be an inconstant finding and the Horner's syndrome incomplete. Ophthalmologists must be aware of this entity because they are the first and often only practicians to be consulted. They must consider the diagnosis, ask for an immediate MRI or angio-scan, start the treatment and assume the follow-up.

Adult↗
PubMed2001

Horner syndrome associated with implantation of a vagus nerve stimulator.

PURPOSE: To report a case of Horner syndrome that occurred after implantation of a vagus nerve stimulator. METHODS: Case report. RESULTS: A 6-year-old female with cerebral dysgenesis and intractable partial seizures presented with Horner syndrome after vagus nerve stimulator implantation. CONCLUSION: Horner syndrome can occur as a result of the vagus nerve stimulator implant procedure and should be included as one of its possible surgical complications.

Blepharoptosis↗
PubMed2002

Isolated Horner syndrome and syrinx of the cervical spinal cord.

PURPOSE: To alert ophthalmologists to the possibility of a spinal cord lesion in individuals with Horner syndrome and no neurologic symptoms. DESIGN: Observational case report. METHODS: Neuro-ophthalmic and neuroimaging assessment of a 16-year-old man with an isolated Horner syndrome localizing to a first- or second-order neuron. RESULTS: With magnetic resonance imaging, a syrinx of the cervical spinal cord extending from C5 to C7 was found. No Chiari malformation was present. CONCLUSION: Patients with an isolated Horner syndrome localizing to a first- or second-order sympathetic neuron should undergo magnetic resonance imaging of the head, neck, spinal cord, and chest to investigate for possible origins. An isolated Horner syndrome may be the presenting manifestation of a cervical syrinx.

Adolescent↗
PubMed2006

[Three cases of abducens nerve palsy accompanied by Horner syndrome].

PURPOSE: To report three cases of nasopharyngeal carcinoma, exhibiting abducens nerve palsy and Horner syndrome during the medical treatment of the tumor, whose invasive cavernous sinus lesions could be detected. SUBJECTS: The patients were two men and one woman who were referred to our department with complaints of diplopia during the clinical course of nasopharyngeal carcinoma. RESULTS: Right abducens nerve palsy, Horner syndrome, and impairment of the 1st division of the trigeminal nerve were recognized in all patients. Magnetic resonance imaging (MRI) revealed invasive lesions in the right cavernous sinus in all three patients, with iso-intensity on T1-weighted images, which were enhanced by gadolinium. CONCLUSIONS: The abducens and sympathetic nerves run closely together in the cavernous sinus. Nasopharyngeal carcinoma is apt to invade the cavernous sinus and often impairs the abducens nerve. Therefore the presence of Horner syndrome and trigeminal palsy in combination with abducens nerve palsy should be cautiously investigated to confirm the existence of the cavernous sinus lesions.

Abducens Nerve Diseases↗
PubMed1987

Horner syndrome occurring as a complication of chest tube placement.

A case of Horner syndrome occurring secondary to the high insertion of a chest tube is reported. Horner syndrome from this cause can easily be avoided. The tip of the chest tube should be kept at or below the third posterior rib unless the clinical situation dictates otherwise.

Adult↗
PubMed2000

Acute Horner syndrome due to thoracic epidural analgesia in a paediatric patient.

A 4-year-old boy with coarctation of the aorta underwent surgical aortic arch repair with general anaesthesia and thoracic epidural analgesia. In the immediate postoperative period, the child developed a unilateral Horner syndrome which appeared to be related to the epidural infusion rate. Management of this patient as well as alternate aetiologies of Horner syndrome are described. Horner syndrome is a rare complication of epidural catheters and is often unrecognized, especially in children.

Acute Disease↗
PubMed1993

Herpes zoster ophthalmicus as a cause of Horner syndrome.

Herpes zoster ophthalmicus is a disease in which the varicella-zoster virus replicates and produces inflammation in the skin of the face supplied by the sensory branches of the ophthalmic division of the trigeminal nerve. It can also cause a conjunctivitis, keratitis, uveitis, extraocular muscle paralysis, and acute retinal necrosis. We found only a single report of this disease as a cause of Horner syndrome. Here we report a case of herpes zoster ophthalmicus that progressed to a sixth nerve palsy and, subsequently, a Horner syndrome. We discuss how the anatomic relationship of the fifth, sixth, and sympathetic nerves in the cavernous sinus provides a route whereby the varicella-zoster virus may produce a Horner syndrome. To our knowledge this is the first fully documented case of Horner syndrome caused by herpes zoster ophthalmicus.

Herpes Zoster Ophthalmicus↗
PubMed2001

[Assisted thoracoscopic resection of huge mediastinal neurogenic tumor with Horner syndrome and superior vena cava syndrome].

A 51-year-old female suffering from right shoulder pain had chest radiography, which showed the huge round shadow (10 x 8.5 x 8.0 cm) on the right upper lung field. Horner syndrome and superior vena cava syndrome were presented. Thoracoscopic appearance showed that the tumor with complete smooth capsulation was neurogenic. After that added ideal thoracotomy (compatible with location and length) was performed, from which tumor was carried out and made a pathologic diagnosis of neurilemoma originated from thoracic sympathetic nerve. Harmonic Scalpel, an ultrasonically activated surgical device was effective in such a case of using near by nerve and small vessels. After operation, superior vena cava syndrome except for Horner syndrome was improved. It is important that we should consider less invasive and safe approach with combination of thoracoscopic and thoracotomic procedures even in case of huge tumor.

Female↗
PubMed1988

Congenital cervical neuroblastoma associated with Horner syndrome.

A rare case of congenital neuroblastoma of the neck associated with complete Horner syndrome and respiratory distress is described. The case was successfully treated by total excision secondary to chemotherapy. Horner syndrome was of value for early diagnosis of this lesion.

Female↗
PubMed2006

Comparing efficacies of 0.5% apraclonidine with 4% cocaine in the diagnosis of horner syndrome in pediatric patients.

PURPOSE: The aim of this study was to compare the efficacy of 0.5% apraclonidine with that of 4% cocaine and to evaluate its safety in the diagnosis of Horner syndrome in pediatric patients. METHODS: This was a randomized, crossover study, wherein 10 patients with a probable diagnosis of Horner syndrome were assigned to undergo pharmacological testing with 4% cocaine and 0.5% apaconidine. The difference in the pupil diameters of each eye was recorded under dim light before and 1 h after 0.5% apraclonidine or 4% cocaine was instilled. Any adverse effects were noted during examination or reported by the patients' parents were recorded. RESULTS: The mean differences in pupil diameter before and after 4% cocaine testing were -2.08 and -2.97 mm, respectively (P = 0.0047). All patients had an anisocoria greater than 1 mm after 4% cocaine testing. The mean difference in pupil diameter before and after 0.5% apraclonidine was instilled were -2.04 and +1.08 mm, respectively (P = 0.005). All patients showed a reversal of anisocoria after 0.5% apraclonidine testing. Conjunctival hyperemia was noted in 2 patients, but systemic adverse effects were not noted during examination nor reported by the patients' parents. CONCLUSIONS: The application of 0.5% apraclonidine in pediatric patients is safe and effective in the diagnosis of Horner syndrome.

Adolescent↗
PubMed2005

[Diagnosis of horner syndrome by pupil dilation lag].

BACKGROUND: In the first seconds after switching off the lights, Horner pupils often show a dilation lag. This dilation lag is diagnostic for Horner syndrome. We investigated whether the visibility of the dilation lag can be improved by increasing the amplitude of pupil dilation. PATIENTS AND METHODS: In four patients with pharmacologically confirmed Horner syndrome pupil sizes were registered bilaterally simultaneously with an infrared camera. Dilation lag was induced by switching off the light while the patient was fixating at distance or by turning off the light and changing fixation from near to far at the same time. An increase of anisocoria of 0.5 mm or more within the first 4 seconds was interpreted as dilation lag. RESULTS: Dilation lags were seen in one patient with both methods, in two patients only with the second method, and in one patient with neither method. CONCLUSIONS: Dilation lag visibility can be improved by asking the patient to change fixation from near to far at the moment when the lights are switched off.

Adult↗
PubMed1992

Acquired heterochromia with horner syndrome in two adults.

BACKGROUND: Heterochromia iridis, asymmetry of iris pigmentation, has been well described with congenital Horner syndrome. Acquired heterochromia associated with lesions in the ocular sympathetic pathways in adulthood, however, is rare. METHODS: Two cases are reported in which sympathectomy in adults resulted in ipsilateral Horner syndrome with heterochromia. In each case, pharmacologic testing with cocaine and hydroxyamphetamine was performed. RESULTS: In both cases, sympathectomy occurred at the level of the second order neuron, but hydroxyamphetamine testing suggested at least partial third order neuron involvement. CONCLUSION: Acquired heterochromia can occur in adults. The partial response to hydroxyamphetamine in the two cases presented may reflect trans-synaptic degeneration of the postganglionic neuron. A reduction in trophic influences on iris melanocytes may have contributed to the observed heterochromia.

Aged↗
PubMed2003

Pituitary apoplexy causing optic neuropathy and horner syndrome without ophthalmoplegia.

A 47-year-old woman presented with headache, acute monocular vision loss, and ipsilateral Horner syndrome. Apart from the optic neuropathy, all cranial nerve function was intact. Magnetic resonance imaging revealed an enlarged pituitary gland with compression of the orbital apex. The surgical specimen was consistent with pituitary apoplexy. The combination of headache, acute visual loss, and ipsilateral Horner syndrome without ophthalmoplegia, which may suggest carotid artery dissection, is evidently an unusual manifestation of pituitary apoplexy.

Anti-Inflammatory Agents↗
PubMed1998

Painful Horner syndrome due to arteritis of the internal carotid artery.

A 44-year-old man presented with painful Horner syndrome: severe periorbital pain, ptosis, and miosis of his right eye, with intact facial sweating. Lymphadenitis at the right side of his neck preceded the symptoms. MRI and magnetic resonance angiography showed thickening of the right internal carotid artery, extending from the bifurcation to the cavernous sinus, without evidence for dissection. The patient was treated with corticosteroids with immediate improvement. Control MRI scanning was normal after 6 weeks. We conclude that the painful Horner syndrome was caused by a reactive arteritis of the right internal carotid artery.

Adult↗
PubMed2006

Abducens nerve palsy and postganglionic Horner syndrome with or without severe headache.

OBJECTIVE: To report the clinical features of 9 patients with both abducens nerve palsy and postganglionic Horner syndrome. PATIENTS AND METHODS: Nine patients with this symptom combination were examined by our Neuro-ophthalmology Clinic in Nihon University Itabashi Hospital between 1978 and 2004. Patient ages ranged from 28 to 63 years (average 47.2+/-8.7 years). Six patients were males and 3 were females. Primary diseases, accompanying symptoms and prognoses were surveyed. RESULTS: In primary diseases, neoplasm in the cavernous sinus was observed in 2 patients, sphenoidal sinus cyst in 2, intra-cavernous carotid aneurysm in 2, epipharynx carcinoma in 1, chordoma in the base of the skull in 1, and meningioma in the middle cranial fossa in 1. Five patients with extra-cavernous sinus lesions; sphenoidal sinus cyst, epipharynx carcinoma, chordoma and meningioma, complained of severe headache. However, in patients without severe headache, intra-cavernous sinus lesions such as carotid aneurysm and metastatic carcinoma were detected. After therapy, abducens nerve palsy improved in 5 patients, however, Horner syndrome persisted in all patients. CONCLUSION: We emphasize that this symptom combination is an important sign of lesions in the posterior portion of the cavernous sinus or in its vicinity. Moreover, the presence or absence of severe headache depends on whether the lesion is in the intra-cavernous or extra-cavernous sinus.

Abducens Nerve Diseases↗