Horner's syndrome following attempted internal jugular venous cannulation

Abstract

DiscussionIt is unclear why pamidronate should have a selective effect in inducing an inflammatory reaction in the orbital tissues, with no apparent effect on muscle function elsewhere in the body. It is probable that the intraorbital inflammation and consequent oedema involved the recti muscles during both the episodes. If the effects of intraorbital oedema on muscle function were not equal bilaterally, as is evident from Hess chart (Figure 1) recorded during the second episode, then diplopia during conjugate eye movements would be expected. Diplopia in the primary position may have been due to breakdown of a small pre-existing vertical phoria, although none was clinically evident when he was assessed after resolution of the second episode.

Iatrogenic Horner's syndrome: A cause for diagnostic confusion in the emergency department

“…[1] These fibers are normally less prone for injury and excessive rotation of neck during IJV CVC placement may alter the anatomical relationship between the two and predispose them to injury. [2] Neck hematoma resulting from accidental carotid puncture during IJV CVC placement can compress and injure ansa subclavia, the part of sympathetic chain connecting middle and inferior cervical sympathetic ganglia. [2] Hematoma can interfere with blood supply to superior cervical ganglion as well.…”

Horner's syndrome secondary to internal jugular venous cannulation

“…The syndrome is caused by functional interruption of sympathetic innervation to the pupil, levator palpebrae, conjuctivae, and face [1,4,5]. The right IJV is preferred as a central venous cannulation access site because it has predictable anatomy, a low risk of pneumothorax, and a high success rate in children and adults [6].…”

“…Most of the reports are related to regional anesthetic techniques in adults, such as brachial plexus block and thoracic and lumbar epidural anesthesia, particularly in obstetrical patients [1][2][3]. There are some earlier reports of Horner's syndrome following internal jugular venous (IJV) cannulation, of which one describes a pediatric patient [4,5]. We report a case of transient Horner's syndrome secondary to IJV cannulation, which resolved completely after 5 months.…”

Case report of Horner's syndrome complicating internal jugular venous cannulation in a child

“…All cases documented difficulty of venous cannulation and multiple attempts. Three were associated with immediate hematoma formation (4–6), one with significant hypoxic brain injury (7) and the last one with external jugular vein cannulation but no hematoma formation (10). The cases associated with hematoma formation had differing outcomes.…”

“…Follow‐up beyond four months was not documented (7). The fifth case described a Horner's Syndrome with no associated hematoma that resolved after 18 days (10). This case and our case suggest that Horner's syndrome after IJ cannulation can occur without hematoma formation or central hypoxic insult.…”