Paiva Wellingson Silva, De Amorim Robson Luis Oliveira, Tavares Wagner Malago, Alho Eduardo Joaquim Lopes, Jeng Brasil Ping, Figueiredo Eberval Gadelha
Hospital das Clínicas, University of São Paulo, Rua Ovidio Pires de Campos 171/511, São Paulo, SP, Brazil.
Arq Neuropsiquiatr. 2007 Dec;65(4A):1037-9. doi: 10.1590/s0004-282x2007000600026.
Horner's syndrome is the triad of miosis, ptosis, and anhidrosis, resulting from disruption of the sympathetic pathways. This article describes an uncommon case of Horner's syndrome in a 22-year-old man after blunt trauma to the neck and chest without carotid artery dissection. The patient was brought to the emergency service after motorcycle fall. Neurologic examination revealed a patient presenting the score 15 at Glasgow Coma Scale. The left eyelid was 1-2 mm lower than the right. Carotid Doppler and angiotomography were undertaken and revealed no abnormalities of the carotid artery. CT disclosed a mediastinal hematoma extending to the left apex, compressing the left sympathetic chain. The understanding of this clinical entity may help the surgeon to make a better differential diagnosis in trauma patients in whom prompt diagnosis is critical to establish the correct treatment.
霍纳综合征是由交感神经通路中断引起的瞳孔缩小、上睑下垂和无汗三联征。本文描述了一例罕见的霍纳综合征病例,患者为一名22岁男性,颈部和胸部钝性创伤后未发生颈动脉夹层。患者因摩托车摔倒后被送往急诊。神经系统检查显示患者格拉斯哥昏迷量表评分为15分。左侧眼睑比右侧低1 - 2毫米。进行了颈动脉多普勒检查和血管造影,未发现颈动脉异常。CT显示纵隔血肿延伸至左肺尖,压迫左侧交感神经链。对这一临床实体的认识有助于外科医生在创伤患者中做出更好的鉴别诊断,对于这些患者,及时诊断对于确立正确的治疗至关重要。