Horner Syndrome, from Suspicion to Diagnosis Confirmation and Treatment

Detalhes bibliográficos
Autor(a) principal: Costa, Magda
Data de Publicação: 2024
Outros Autores: Correia de Sá, Ana Correia de Sá, Pires, Joana Pires, Gonçalves, Filipe Gonçalves, Cotter, Jorge Cotter
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://doi.org/10.60591/crspmi.99
Resumo: 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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spelling Horner Syndrome, from Suspicion to Diagnosis Confirmation and TreatmentSíndrome de Horner, da Suspeição, À Confirmação Diagnóstica e TratamentoCasos ClínicosHorner 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.A síndrome de Horner (SH) é caracterizado por ptose, miose e anidrose, devido à interrupção da via do oculossimpático ao longo dos segmentos cefálico, ocular ou cervical. Este caso refere-se a um homem de 53 anos com queixas de cefaleia frontal com 1 semana de evolução, ptose direita e anisocoria. À admissão, a tomografia computorizada crânio-encefálica e dos vasos supra-aórticos com angiografia excluiu evento isquémico, hemorrágico ou disseção carotídea. Ao terceiro teste da apraclonidina, 8 dias após a admissão, foi confirmado SH. Posteriormente realizou ressonância magnética crânio-encefálica que revelou disseção carotídea no segmento cervical da artéria carótida interna direita. Foi instituída anti-agregação simples e anti-dislipidemico. Após 3 meses, objetivou-se resolução da disseção. Neste caso enfatizamos o papel fundamental do teste da apraclonidina na abordagem desta síndrome neurológica e salientamos que uma abordagem terapêutica conservadora permitiu a resolução do caso e minimizou a iatrogenia causada.Sociedade Portuguesa de Medicina Interna2024-02-26info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttps://doi.org/10.60591/crspmi.99eng2975-822XCosta, MagdaCorreia de Sá, Ana Correia de SáPires, Joana PiresGonçalves, Filipe GonçalvesCotter, Jorge Cotterinfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-03-02T09:45:27Zoai:ojs.casereports.spmi.pt:article/99Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:12:11.266745Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Horner Syndrome, from Suspicion to Diagnosis Confirmation and Treatment
Síndrome de Horner, da Suspeição, À Confirmação Diagnóstica e Tratamento
title Horner Syndrome, from Suspicion to Diagnosis Confirmation and Treatment
spellingShingle Horner Syndrome, from Suspicion to Diagnosis Confirmation and Treatment
Costa, Magda
Casos Clínicos
title_short Horner Syndrome, from Suspicion to Diagnosis Confirmation and Treatment
title_full Horner Syndrome, from Suspicion to Diagnosis Confirmation and Treatment
title_fullStr Horner Syndrome, from Suspicion to Diagnosis Confirmation and Treatment
title_full_unstemmed Horner Syndrome, from Suspicion to Diagnosis Confirmation and Treatment
title_sort Horner Syndrome, from Suspicion to Diagnosis Confirmation and Treatment
author Costa, Magda
author_facet Costa, Magda
Correia de Sá, Ana Correia de Sá
Pires, Joana Pires
Gonçalves, Filipe Gonçalves
Cotter, Jorge Cotter
author_role author
author2 Correia de Sá, Ana Correia de Sá
Pires, Joana Pires
Gonçalves, Filipe Gonçalves
Cotter, Jorge Cotter
author2_role author
author
author
author
dc.contributor.author.fl_str_mv Costa, Magda
Correia de Sá, Ana Correia de Sá
Pires, Joana Pires
Gonçalves, Filipe Gonçalves
Cotter, Jorge Cotter
dc.subject.por.fl_str_mv Casos Clínicos
topic Casos Clínicos
description 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.
publishDate 2024
dc.date.none.fl_str_mv 2024-02-26
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://doi.org/10.60591/crspmi.99
url https://doi.org/10.60591/crspmi.99
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 2975-822X
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv Sociedade Portuguesa de Medicina Interna
publisher.none.fl_str_mv Sociedade Portuguesa de Medicina Interna
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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