Cases reported "Horner Syndrome"

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1/256. Fracture of the first rib.

    Fifteen cases of isolated fracture of the first rib are submitted. The mechanism of the fracture is discussed. It proved compatible with the descriptions in the literature, caused either by direct trauma to the shoulder, a sudden violent contraction of juxtacostal muscles; or else it was a chance finding, without any history of trauma and as such interpreted as a fatigue fracture. A case of Horner's syndrome complicating a fracture of the first rib is also described. ( info)

2/256. Traumatic horner syndrome without anhidrosis.

    In a patient with a traumatic avulsion of the arm, magnetic resonance imaging showed the exact site of the lesion that produced horner syndrome with preservation of sweating on the face. ( info)

3/256. Endovascular occlusion of a carotid pseudoaneurysm complicating deep neck space infection in a child. Case report.

    Pseudoaneurysm formation of the cervical internal carotid artery (ICA) is a rare, potentially lethal complication of deep neck space infection. This entity typically occurs following otolaryngological or upper respiratory tract infection. The pseudoaneurysm is heralded by a pulsatile neck mass, Homer's syndrome, lower cranial neuropathies, and/or hemorrhage that may be massive. The recommended treatment includes prompt arterial ligation. The authors present a case of pseudoaneurysm of the cervical ICA complicating a deep neck space infection. A parapharyngeal staphylococcus aureus abscess developed in a previously healthy 6-year-old girl after she experienced pharyngitis. The abscess was drained via an intraoral approach. On postoperative Day 3, the patient developed a pulsatile neck mass, lethargy, ipsilateral Horner's syndrome, and hemoptysis, which resulted in hemorrhagic shock. Treatment included emergency endovascular occlusion of the cervical ICA and postembolization antibiotic treatment for 6 weeks. The patient has made an uneventful recovery as of her 18-month follow-up evaluation. Conclusions drawn.from this experience and a review of the literature include the following: 1) mycotic pseudoaneurysms of the carotid arteries have a typical clinical presentation that should enable timely recognition; 2) these lesions occur more commonly in children than in adults; 3) angiography with a view to performing endovascular occlusion should be undertaken promptly; and 4) endovascular occlusion of the pseudoaneurysm is a viable treatment option. ( info)

4/256. 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. ( info)

5/256. 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. ( info)

6/256. Primary mediastinal hydatid cyst.

    An unusual case of primary mediastinal echinococcosis in a young female presented with non-specific symptoms. On examination, she had signs of Horner's syndrome and mild superior vena cava compression. She was operated successfully. The final diagnosis could only be made on the operating table and confirmed by histopathology. Hydatid cyst in mediastinum is uncommon but because of surrounding vital structures and potential of its complete cure should be explored without delay. ( info)

7/256. Congenital Horner's syndrome resulting from agenesis of the internal carotid artery.

    OBJECTIVE: To report a patient with agenesis of the right internal carotid artery associated with ipsilateral, congenital Homer's syndrome. DESIGN: Case report. methods: A 30-year-old woman, with a past history of migraine headaches, underwent neuro-ophthalmologic and neuroradiologic evaluation for transient visual obscurations and congenital Horner's syndrome. RESULTS: A right, third-order neuron Horner's syndrome was confirmed with 1% hydroxyamphetamine topical drops. Cranial magnetic resonance imaging revealed an absent right internal carotid artery flow void, computed tomography demonstrated absence of the right carotid canal, and cerebral angiography confirmed absence of the right internal carotid artery. No atheromatous lesions were found and the results of coagulation studies were normal. CONCLUSIONS: Agenesis of the internal carotid artery is a rare cause of congenital Horner's syndrome. The cause of transient visual blurring in the current patient remains unproven. ( info)

8/256. Schwannoma of the cervical sympathetic chain. The virginia experience.

    We present 4 cases of schwannomas arising from the cervical sympathetic chain. These lesions are uncommon and most often present as an asymptomatic solitary neck mass. Preoperative diagnosis can be difficult, even with the aid of computed tomography, magnetic resonance imaging, ultrasound, and angiography. While a paraganglioma can often be ruled out, exact determination of the nerve of origin is frequently elusive until the time of surgery. Operative excision remains the treatment of choice, often requiring sacrifice of a portion of the sympathetic chain. Postoperative Horner's syndrome is common, but does not appear to have an adverse effect on the patient. ( info)

9/256. Horner'sy syndrome and its significance in the management of head and neck trauma.

    The history, mechanism and aetiology of Horner'sy Syndrome is presented and the pharmacology of the pupil is discussed. The case reported is a rare combination of Horner's Syndrome in a patient who sustained bilateral fractures of the mandible and a chest injury. It is emphasised that the miotic changes in Horner's Syndrome, in combination with head injuries can lead to confusion in diagnosis and the potential anaesthetic hazards and their influence on the management of the facial injury are outlined. ( info)

10/256. horner syndrome with equal-sized pupils in a case with underlying physiologic anisocoria.

    A case is presented in which horner syndrome occurred on the side of the larger pupil in underlying physiologic anisocoria. The unusual coincidence resulted in ipsilateral ptosis, but with clinically equal-sized and normally reactive pupils. ( info)
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