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1.
J Clin Ultrasound ; 51(1): 203-209, 2023 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-36165415

RESUMEN

Horner Syndrome (HS) is characterized by symptoms of ipsilateral miosis, ptosis, enophthalmos, and facial anhidrosis, which is caused by the damaged oculosympathetic pathway. HS is rarely reported as postoperative complications of fine-needle aspiration (FNA). We report a case of HS triggered by Ultrasound-guided FNA during thyroid cancer management and conducted the literature review. A 31-year-old male with differentiated thyroid cancer underwent total thyroidectomy and regional lymph node dissection as well as radioactive iodine ablation, presented with persistently elevated tumor marker of thyroglobulin and suspicious left level IV and V cervical lymph nodes by neck ultrasound. Ultrasound-guided left cervical lymph nodes FNA for cellular diagnosis was performed, and typical manifestations of HS appeared immediately after the procedure. Subsequent ultrasound evaluation of the same area demonstrated a subtle strip of the hypo-echogenic area in the superior pole of the suspected level IV structure, suggesting sympathetic ganglia with the visible originating nerve fiber on the superior pole. All of the patient's symptoms of HS were resolved 2 months after the incidence. Cervical sympathetic ganglia can be similar in size, shape, and ultrasound characteristics to a malignant lymph node. Thorough ultrasound examination by directly comparing the potential ganglia with a typical malignant lymph node, and paying attention to any potential root fibers on the target is key to avoiding ganglia injury before the neck invasive procedures.


Asunto(s)
Carcinoma Papilar , Síndrome de Horner , Neoplasias de la Tiroides , Masculino , Humanos , Adulto , Neoplasias de la Tiroides/complicaciones , Neoplasias de la Tiroides/diagnóstico por imagen , Neoplasias de la Tiroides/cirugía , Biopsia con Aguja Fina/efectos adversos , Síndrome de Horner/etiología , Síndrome de Horner/patología , Radioisótopos de Yodo , Carcinoma Papilar/metabolismo , Carcinoma Papilar/patología , Carcinoma Papilar/cirugía , Ganglios Linfáticos/patología , Ultrasonografía Intervencional
2.
Arch Soc Esp Oftalmol (Engl Ed) ; 97(5): 281-285, 2022 May.
Artículo en Inglés | MEDLINE | ID: mdl-35526951

RESUMEN

We present a clinical situation where a 47-year old female patient consulted with left partial ptosis and miosis that started, two weeks before, with an episode of glandular fever secondary to Epstein-Barr infection. Apraclonidine 0.5% and Phenylephrine 1% drop testing was performed with results consistent with suspected left Horner Syndrome (HS), with a probable postganglionic location. Magnetic Resonance Angiography (MRA) at the moment of the acute presentation did not show any image suggesting carotid arterial dissection but showed irregular narrowing of the left internal carotid artery on its paravertebral extracranial way, consistent to enlarged intra-carotid sheath lymphoid tissue. A week later, a Doppler ultrasound was performed, showing bilateral images compatible with internal carotid arterial dissection. When Postganglionar HS is suspected, the first aetiology to rule out is a carotid arterial dissection because of its potentially fatal outcome and for being a more described entity as postganglionic HS aetiology. However, it is also evidenced that a certain diagnose is not always possible. Furthermore, we describe the enlarged internal carotid artery sheath lymphoid tissue as a possible cause of sympathetic nerve disruption causing a Postganglionar HS, although not common.


Asunto(s)
Infecciones por Virus de Epstein-Barr , Síndrome de Horner , Mononucleosis Infecciosa , Arteria Carótida Interna/patología , Infecciones por Virus de Epstein-Barr/complicaciones , Infecciones por Virus de Epstein-Barr/patología , Femenino , Herpesvirus Humano 4 , Síndrome de Horner/diagnóstico , Síndrome de Horner/etiología , Síndrome de Horner/patología , Humanos , Mononucleosis Infecciosa/complicaciones , Mononucleosis Infecciosa/patología , Persona de Mediana Edad
4.
BMJ Case Rep ; 13(12)2020 Dec 12.
Artículo en Inglés | MEDLINE | ID: mdl-33310822

RESUMEN

Horner's syndrome is a rare neurological condition seen in association with the disruption in the sympathetic nerve supply. Thyroid swelling is a common condition but rarely causes cervical sympathetic chain compression. We describe a case of a 54-year-old man who presented with Horner's syndrome secondary to a benign thyroid nodule with pressure effect on the sympathetic chain. An association between thyroid pathologies and Horner's syndrome has been mentioned previously, however, to our knowledge, this is the first case of Horner's syndrome being the initial presentation for an underlying benign thyroid swelling.


Asunto(s)
Síndrome de Horner/etiología , Enfermedades de la Tiroides/complicaciones , Edema/etiología , Síndrome de Horner/patología , Síndrome de Horner/cirugía , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Enfermedades de la Tiroides/patología , Enfermedades de la Tiroides/cirugía , Tiroidectomía , Resultado del Tratamiento
5.
Neurol Sci ; 40(6): 1311-1314, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-30790081

RESUMEN

OBJECTION: We herein report cervicothoracic spinal root cysts as a rare cause of Horner's syndrome. CASE REPORT: A 62-year-old woman was admitted to our neuro-ophthalmology clinic complaining of drooping of her right upper eyelid. The history, physical examination, and laboratory tests were normal. The extraocular movements were full. The right eyelid was ptotic and the right pupil was smaller than the left. Right Horner's syndrome was diagnosed by the neuro-ophthalmologic examination and pharmacological tests. Cervical magnetic resonance imaging showed multiple spinal nerve root cysts between C7 and T1 segments of the spinal cord. CONCLUSION: This report showed for the first time that cervicothoracic spinal root cysts could cause Horner's syndrome and should be kept in mind in performing neuroimaging studies.


Asunto(s)
Médula Cervical/patología , Síndrome de Horner/etiología , Quiste Mediastínico/complicaciones , Quiste Mediastínico/patología , Raíces Nerviosas Espinales/patología , Médula Cervical/diagnóstico por imagen , Femenino , Síndrome de Horner/diagnóstico por imagen , Síndrome de Horner/patología , Humanos , Quiste Mediastínico/diagnóstico por imagen , Persona de Mediana Edad , Raíces Nerviosas Espinales/diagnóstico por imagen
6.
World J Surg Oncol ; 16(1): 209, 2018 Oct 17.
Artículo en Inglés | MEDLINE | ID: mdl-30333040

RESUMEN

BACKGROUND: Chondroma is a slowly growing, benign cartilaginous tumor which predominantly occurs in long bones of the hands and feet. Primary mediastinal chondroma is rare, especially with Horner's syndrome. CASE PRESENTATION: We reported the case of a 31-year-old woman with a posterior mediastinum mass associated with Horner's syndrome. After complete dissection of the mass, a pathological diagnosis of the primary mediastinal chondroma was rendered. The patient has shown no local recurrence or distal disease in a 3.5-year follow-up period. CONCLUSIONS: The preoperative diagnosis of chondroma should combine various examinations for comprehensive evaluation. Complete surgical resection should be the first choice of the treatment due to the risk of malignancy.


Asunto(s)
Condroma/patología , Síndrome de Horner/patología , Neoplasias del Mediastino/patología , Adulto , Condroma/complicaciones , Condroma/cirugía , Femenino , Síndrome de Horner/complicaciones , Síndrome de Horner/cirugía , Humanos , Neoplasias del Mediastino/complicaciones , Neoplasias del Mediastino/cirugía , Pronóstico
7.
J Clin Neurosci ; 56: 188-191, 2018 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-29937417

RESUMEN

The well-known sensory deficit in lateral medullary syndrome (LMS) involves crossed ipsilateral trigeminal area and contralateral spinothalamic tract area. A 45 year old man was admitted for sudden onset slurring of speech, unsteadiness and sensory complaints. The diagnosis was right lateral medullary syndrome due to right Vertebral Artery occlusion. In addition to typical lateral medullary syndromes, his sensory deficit involved contralateral half of the face, trunk and limbs. We report this atypical sensory presentation and discuss its neuroanatomical correlation.


Asunto(s)
Arteriopatías Oclusivas/diagnóstico por imagen , Infarto Encefálico/diagnóstico por imagen , Síndrome de Horner/diagnóstico por imagen , Bulbo Raquídeo/diagnóstico por imagen , Arteriopatías Oclusivas/complicaciones , Arteriopatías Oclusivas/patología , Infarto Encefálico/complicaciones , Infarto Encefálico/patología , Síndrome de Horner/complicaciones , Síndrome de Horner/patología , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Arteria Vertebral/diagnóstico por imagen
9.
Mycopathologia ; 181(11-12): 885-889, 2016 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-27255521

RESUMEN

Pseudomembranous aspergillus tracheobronchitis is an uncommon form of invasive pulmonary aspergillosis, and it is generally seen in immunocompromised patients. We report about a mildly immunocompromised case with pseudomembranous aspergillus tracheobronchitis, which caused tracheal perforation, and Horner's syndrome. A 44-year-old female with uncontrolled diabetes mellitus, complaining of fever and dyspnea, was admitted to the hospital. She was hospitalized with community-acquired pneumonia and diabetic ketoacidosis. Insulin infusion and empirical antibiotics were firstly commenced. Bronchoscopy showed left vocal cord paralysis with extensive whitish exudative membranes covering the trachea and the main bronchi. Liposomal amphotericin B was added due to the probability of fungal etiology. Mucosal biopsy revealed aspergillus species. Second bronchoscopic examination demonstrated a large perforation in the tracheobronchial system. Despite all treatments, respiratory failure developed on the 25th day and the patient died within 2 days. Pseudomembranous aspergillus tracheobronchitis is fatal in about 78 % of all cases despite appropriate therapy. Early diagnosis and efficient antifungal therapy may improve the prognosis.


Asunto(s)
Aspergilosis/diagnóstico , Aspergillus/aislamiento & purificación , Bronquitis/etiología , Síndrome de Horner/diagnóstico , Perforación Espontánea/diagnóstico , Traqueítis/etiología , Adulto , Anfotericina B/administración & dosificación , Antifúngicos/administración & dosificación , Aspergilosis/complicaciones , Aspergilosis/microbiología , Aspergilosis/patología , Biopsia , Bronquitis/complicaciones , Bronquitis/microbiología , Bronquitis/patología , Resultado Fatal , Femenino , Síndrome de Horner/patología , Humanos , Perforación Espontánea/patología , Tráquea/patología , Traqueítis/complicaciones , Traqueítis/microbiología , Traqueítis/patología
12.
Pediatr Radiol ; 45(10): 1535-43, 2015 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-25832988

RESUMEN

BACKGROUND: Horner syndrome in children is rare. The frequency and spectrum of malignancy as the cause of Horner syndrome in children remains unclear. Also unclear is whether the imaging work-up should include the entire oculo-sympathetic pathway or should be more targeted. In addition, the value of cross-sectional angiographic imaging in Horner syndrome is uncertain. OBJECTIVE: To review imaging pathology in a cohort of children with Horner syndrome at a major academic pediatric medical center. MATERIALS AND METHODS: We reviewed a 22-year period of CT and MR imaging studies in children with a clinical diagnosis of Horner syndrome referred for imaging. RESULTS: We found 38 patients who fulfilled study criteria of Horner syndrome and 6/38 had relevant imaging findings: 2/6 etiologies were neoplastic (congenital neuroblastoma and central astrocytoma), 1/6 had a vascular abnormality (hypoplastic carotid artery), 1/6 had maldevelopment (Chiari I malformation), and 2/6 had inflammatory/traumatic etiology (viral cervical lymphadenopathy, post jugular vein cannulation). There was a similar number of congenital and acquired pathologies. The malignancies were found at any level of the oculosympathetic pathway. CONCLUSION: There are treatable causes, including malignancies, in children presenting with Horner syndrome, which justify imaging work-up of the entire oculosympathetic pathway, unless the lesion level can be determined clinically.


Asunto(s)
Ojo/diagnóstico por imagen , Ojo/patología , Síndrome de Horner/diagnóstico por imagen , Síndrome de Horner/patología , Neuroimagen , Adolescente , Adulto , Niño , Preescolar , Estudios de Cohortes , District of Columbia , Femenino , Humanos , Lactante , Recién Nacido , Imagen por Resonancia Magnética , Masculino , Estudios Retrospectivos , Tomografía Computarizada por Rayos X , Adulto Joven
14.
Vet Ophthalmol ; 18(1): 1-5, 2015 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-24028692

RESUMEN

OBJECTIVE: To investigate whether idiopathic Horner's syndrome (HS) in Golden Retrievers is an exclusively preganglionic disorder based on denervation hypersensitivity pharmacological testing with phenylephrine. ANIMALS STUDIED: Medical records of dogs presented with HS between 2000 and 2012. Dogs presented with additional ocular or systemic signs were excluded. PROCEDURES: Clinical data examined included age, sex, duration of clinical signs, ancillary diagnostic test results, and time to mydriasis on topical ocular application of 1% phenylephrine. Lesions were diagnosed as postganglionic (mydriasis within 20 min) or preganglionic (mydriasis between 20 and 45 min). RESULTS: Medical records of 21 dogs of nine different breeds were included. An etiopathogenesis for Horner's syndrome was determined in five dogs, none of which were Golden Retrievers. All diagnoses correlated with pharmacological lesion localization. Ten Golden Retrievers were included (eight male and two female) with a mean age of 8.5 years (range: 4-13). Lesion localization was diagnosed as postganglionic in eight (mean: 10 min [range: 6-18]) and preganglionic in two Golden Retrievers (20 and 24 min). All cases were unilateral and had completely resolved within 15 weeks (range: 11-20). Recurrence was not reported in any of the patients. CONCLUSIONS: Idiopathic postganglionic HS was diagnosed in eight of 10 Golden Retrievers contradicting previous reports of a purely preganglionic localization. Etiopathogenesis of canine idiopathic HS remains to be determined; nevertheless, a vascular etiology cannot be excluded. Future studies using magnetic resonance angiography may aid in clarifying the pathogenesis.


Asunto(s)
Enfermedades de los Perros/patología , Síndrome de Horner/veterinaria , Animales , Fibras Autónomas Preganglionares/efectos de los fármacos , Fibras Autónomas Preganglionares/patología , Blefaroptosis/diagnóstico , Blefaroptosis/patología , Blefaroptosis/veterinaria , Enfermedades de los Perros/diagnóstico , Perros , Femenino , Síndrome de Horner/diagnóstico , Síndrome de Horner/patología , Masculino , Miosis/diagnóstico , Miosis/patología , Miosis/veterinaria , Fenilefrina/farmacología , Especificidad de la Especie , Fibras Simpáticas Posganglionares/efectos de los fármacos , Fibras Simpáticas Posganglionares/patología , Simpatomiméticos/farmacología
15.
Pediatr Neurol ; 51(3): 417-20, 2014 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-25160548

RESUMEN

BACKGROUND: Horner syndrome after tonsillectomy has been reported rarely in the literature. Furthermore, postoperative Horner syndrome lasting more than a 1 month is an even more rare occurrence. PATIENT: We present a persistent postoperative Horner syndrome in a 5-year-old child following tonsillectomy. RESULTS: Clinical diagnosis of Horner syndrome is confirmed pharmacologically, and damage to the oculosympathetic pathway at the level of the superior cervical ganglion is radiographically demonstrated. CONCLUSION: Conventional monopolar electrosurgical dissection led to irreversible damage of ganglionic neural tissue at the level of the palatine tonsilar fossa and permanent Horner syndrome.


Asunto(s)
Síndrome de Horner/etiología , Síndrome de Horner/patología , Tonsilectomía/efectos adversos , Preescolar , Ojo/patología , Humanos , Imagen por Resonancia Magnética , Masculino , Cuello/diagnóstico por imagen , Cuello/patología , Tomografía Computarizada por Rayos X
17.
Arq Bras Endocrinol Metabol ; 57(6): 483-5, 2013 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-24030189

RESUMEN

An 82-year-old patient presented a progressively growing hard thyroid nodule, and left ptosis. Additionally, ophthalmologic evaluation revealed ipsilateral miosis, diagnostic findings of Horner syndrome. Computerized tomography revealed a 7.5-cm thyroid mass infiltrating the main neck vessels. Although clinical and imaging data were suggestive of poorly differentiated thyroid carcinoma, fine-needle aspiration led to the diagnosis of papillary carcinoma. Paliative care was proposed to the patient due to the advanced stage of the neoplasm and to significant comorbidities. Horner syndrome is an infrequent manifestation of thyroid disorders and benign etiologies are more often implied. Malignant thyroid neoplasms represent a rare cause of Horner syndrome. However, an appropriate and prompt diagnosis is paramount for timely treatment of rare thyroid malignancies.


Asunto(s)
Carcinoma Papilar Folicular/patología , Síndrome de Horner/patología , Glándula Tiroides/patología , Neoplasias de la Tiroides/patología , Anciano de 80 o más Años , Biopsia con Aguja Fina , Diagnóstico Diferencial , Femenino , Síndrome de Horner/diagnóstico , Humanos , Enfermedades Raras , Tomografía Computarizada por Rayos X
18.
Arq. bras. endocrinol. metab ; 57(6): 483-485, ago. 2013. ilus
Artículo en Inglés | LILACS | ID: lil-685411

RESUMEN

An 82-year-old patient presented a progressively growing hard thyroid nodule, and left ptosis. Additionally, ophthalmologic evaluation revealed ipsilateral miosis, diagnostic findings of Horner syndrome. Computerized tomography revealed a 7.5-cm thyroid mass infiltrating the main neck vessels. Although clinical and imaging data were suggestive of poorly differentiated thyroid carcinoma, fine-needle aspiration led to the diagnosis of papillary carcinoma. Paliative care was proposed to the patient due to the advanced stage of the neoplasm and to significant comorbidities. Horner syndrome is an infrequent manifestation of thyroid disorders and benign etiologies are more often implied. Malignant thyroid neoplasms represent a rare cause of Horner syndrome. However, an appropriate and prompt diagnosis is paramount for timely treatment of rare thyroid malignancies.


Paciente de 82 anos apresentando-se com nódulo tireoidiano de crescimento progressivo e ptose palpebral esquerda. O exame oftalmológico revelou ainda miose ipsilateral e achados diagnósticos de síndrome de Horner. A tomografia computadorizada mostrou massa tireoidiana de 7,5 cm infiltrando os grandes vasos do pescoço. Apesar dos dados clínicos e imagiológicos sugestivos de um carcinoma pouco diferenciado da tireoide, a citologia aspirativa foi diagnóstica de carcinoma papilar. Em função do estádio avançado da neoplasia e das comorbilidades significativas, foi proposta para terapêutica paliativa. A síndrome de Horner é uma manifestação clínica infrequente em tumores tireoidianos, estando as condições benignas maioritariamente implicadas. As neoplasias malignas da tireoide representam uma causa rara de síndrome de Horner. Contudo, um diagnóstico adequado e expedito é fundamental para o tratamento atempado nos raros casos de malignidade da tireoide.


Asunto(s)
Anciano de 80 o más Años , Femenino , Humanos , Carcinoma Papilar Folicular/patología , Síndrome de Horner/patología , Glándula Tiroides/patología , Neoplasias de la Tiroides/patología , Biopsia con Aguja Fina , Diagnóstico Diferencial , Síndrome de Horner/diagnóstico , Enfermedades Raras , Tomografía Computarizada por Rayos X
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