Horner's Syndrome After Carotid Endarterectomy

Perry, Charles W.; James, D.D.; Wixon, Christopher L.; Mills, Joseph; Ericksen, Curtis

doi:10.1177/153857440103500414

Cited by 20 publications

(5 citation statements)

References 6 publications

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“…1 In the literature, iatrogenic Horner syndrome is frequently described as resulting from different cervical interventions, including surgery and chiropractic manipulations, subclavian and jugular vein catheterization, insertion of a thorax tube and lumbar anesthesia. [2][3][4][5] We present here a report of Horner syndrome after lymph node fine needle aspiration (LNFNA), which to the best of our knowledge has not yet been described in the literature.…”

Section: To the Editorsmentioning

confidence: 99%

Horner Syndrome After Lymph Node Fine Needle Aspiration

Messika¹,

Telman²

2009

Acta Cytologica

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Section: To the Editorsmentioning

confidence: 99%

Horner Syndrome After Lymph Node Fine Needle Aspiration

Messika¹,

Telman²

2009

Acta Cytologica

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“…Possible complications caused by sympathetic nerve injury during neck surgery include postoperative Horner syndrome [14] and first-bite syndrome [15] ; however, the present case exhibited no symptoms of these conditions. Hence, we believe that there was an ischemic event in the cervical sympathetic trunk during the surgical procedure that drastically reduced sympathetic postganglionic signaling to the heart, but the ischemia did not cause postoperative neuronal palsy sequelae.…”

Section: Discussionmentioning

confidence: 72%

Severe blood pressure elevation following ephedrine administration during carotid endarterectomy under general anesthesia: A CARE-compliant case report

Kim

2023

Medicine

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Rationale: During carotid endarterectomy (CEA) surgery, blood pressure management is particularly important to prevent cerebrovascular and cardiac complications. Ephedrine is a commonly used vasopressor, however, we report the case of a patient with unusually severe blood pressure elevation following intravenous ephedrine administration during CEA.Patient concerns: A 72-year-old man diagnosed with right proximal internal carotid artery stenosis underwent CEA under general anesthesia. After declamping the common carotid artery, blood pressure rapidly increased by 125 mm Hg (from 90 to 215 mm Hg) after ephedrine (4 mg) was administered, but the heart rate was stable.Diagnoses: There was an ordinal increase in blood pressure after the same small dose of ephedrine was administered at the early stage of the surgery. And the surgical approach was difficult because he had a high location of carotid bifurcation and a prominent mandibular angle. Because of the anatomical proximity of the cervical sympathetic trunk to the carotid bifurcation and the particularly complicated surgical process in the present case, we postulate the reason for this adverse reaction as transient sympathetic denervation supersensitivity.Interventions: Perdipine (0.5 mg) was administered repeatedly to reduce blood pressure.Outcomes: After surgery, he was diagnosed with right hypoglossal nerve palsy, and no other abnormal signs were found. Conclusion:This case highlights the need for caution in the use of ephedrine, which is commonly used in CEA surgery, wherein blood pressure management is particularly important. Although it is a rare and unpredictable case, α-agonists are considered safer in situations where sympathetic supersensitivity is possible.

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“…Horner's syndrome can rarely occur after neck surgery. Carotid endarterectomy [ 6 ] and cervical spine surgery [ 8 ] through an anterior approach are considered among the most common causes. Other causes include thyroid and parathyroid surgery [ 9 ], excision of a cervical schwannoma [ 10 ], ganglioneuroma or paraganglioma, cervical lymph node dissection, drainage of a retropharyngeal or parapharyngeal abscess, and sympathectomy [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

“…Central causes include stroke of the posteroinferior cerebellar artery, usually accompanied by other neurological symptoms such as in Wallenberg syndrome. Trauma and tumors are the most common preganglionic lesions of Horner's syndrome [ 4 ], while cluster migraine [ 5 ] and carotid dissection [ 6 ] consist of the most common postganglionic causes. Iatrogenic trauma can occur during various cervical surgical procedures, that is, neck dissection, thyroid, and parathyroid operations [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Horner’s Syndrome Incidental to Medullary Thyroid Carcinoma Excision: Case Report and Brief Literature Review

Mastronikolis

Spiliopoulou

Zolota

et al. 2016

Case Reports in Otolaryngology

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Horner's syndrome is characterized by a combination of ipsilateral miosis, blepharoptosis, enophthalmos, facial anhidrosis, and iris heterochromia in existence of congenital lesions. The syndrome results from a disruption of the ipsilateral sympathetic innervation of the eye and ocular adnexa at different levels. Though rare, thyroid and neck surgery could be considered as possible causes of this clinical entity. We present a case of Horner's syndrome in a patient after total thyroidectomy and neck dissection for medullary thyroid cancer with neck nodal disease and attempt a brief review of the relevant literature.

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Horner's Syndrome After Carotid Endarterectomy

Abstract: Horner's syndrome is described in a patient with anisocoria and unilateral lid ptosis 48 hours after an ipsilateral carotid endarterectomy. This case illustrates a rare iatrogenic complication of sympathetic nerve dysfunction following elective surgery.

Cited by 20 publications

References 6 publications

Horner Syndrome After Lymph Node Fine Needle Aspiration

Horner Syndrome After Lymph Node Fine Needle Aspiration

Severe blood pressure elevation following ephedrine administration during carotid endarterectomy under general anesthesia: A CARE-compliant case report

Horner’s Syndrome Incidental to Medullary Thyroid Carcinoma Excision: Case Report and Brief Literature Review

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