Horner Syndrome, from Suspicion to Diagnosis Confirmation and Treatment
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https://doi.org/10.60591/crspmi.99Keywords:
Carotid Artery, Internal, Dissection, Horner Syndrome/diagnosis, Horner Syndrome/therapyAbstract
Horner syndrome (HS) is characterized by ptosis, miosis
and anhidrosis, due to an interruption of the oculosympathetic pathway along the cephalic, ocular or neck segments. This clinical case reports a 53-year-old man with a one week history of frontal headache, right ptosis and anisocoria. Cerebral and supra-aortic vessels angio-computed tomography was performed, excluding an acute ischemic or hemorrhagic event and carotid dissection. At the third apraclonidine test attempt, 8 days after admission, HS was confirmed. Then a cranioencephalic angio-magnetic resonance imaging was performed, revealing carotid dissection. The patient was proposed to initiate antiplatelet and antilipidemic therapy. After three months, he presented extracranial carotid dissection resolution. In this case, we emphasize the role of the apraclonidine test in this neurologic syndrome approach, and a conservative therapeutic approach allowed not only case resolution,
but also iatrogenic mitigation.
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Copyright (c) 2024 Magda Costa, Ana Correia de Sá Correia de Sá, Joana Pires Pires, Filipe, Jorge
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