Bhavsar Deepaswi, Gandhi Shreya, Magdum Renu, Mushtaq Iqra, Giri Nilesh
Department of Ophthalmology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, IND.
Cureus. 2024 Apr 16;16(4):e58367. doi: 10.7759/cureus.58367. eCollection 2024 Apr.
A 59-year-old male patient came to the outpatient department with complaints of left-sided hemicranial headache with drooping of the left upper eyelid (UL) for three days associated with difficulty in swallowing and deviation of the tongue. The patient had a history of vigorous coughing for the past 15 days for which he did not take any medications. He was thoroughly evaluated in the outpatient department and diagnosed with Horner's syndrome. Acute Horner's syndrome with pain is nearly a hallmark of carotid dissection, and MRI of the brain and orbit was thus advised. On MRI, a hyperdense area was noted around the left internal carotid artery for which he was advised magnetic resonance angiography, which revealed internal carotid artery dissection (ICAD) of the left side. The patient was diagnosed with left-sided Horner's syndrome following left ICAD with involvement of the left hypoglossal nerve. He was started on antiplatelets and anticoagulants and closely followed up. Early diagnosis and prompt treatment were lifesaving for this patient.
一名59岁男性患者因左侧半侧头痛伴左上睑下垂3天前来门诊就诊，同时伴有吞咽困难和舌头偏斜。该患者在过去15天中有剧烈咳嗽史，但未服用任何药物。他在门诊接受了全面评估，被诊断为霍纳综合征。伴有疼痛的急性霍纳综合征几乎是颈动脉夹层的标志，因此建议进行脑部和眼眶的磁共振成像（MRI）检查。在MRI检查中，发现左侧颈内动脉周围有一个高密度区域，为此建议他进行磁共振血管造影，结果显示左侧颈内动脉夹层（ICAD）。该患者在左侧ICAD累及左侧舌下神经后被诊断为左侧霍纳综合征。他开始接受抗血小板和抗凝治疗，并进行密切随访。早期诊断和及时治疗对该患者起到了挽救生命的作用。
