Leira E C, Bendixen B H, Kardon R H, Adams H P
Department of Neurology (Cerebrovascular Diseases), University of Iowa College of Medicine, Iowa City 52242-1053, USA.
Neurology. 1998 Jan;50(1):289-90. doi: 10.1212/wnl.50.1.289.
We describe a 41-year-old woman in whom the diagnosis of carotid artery dissection was suspected based on a recent history of anisocoria and ipsilateral ptosis that lasted 2 days. She had a normal neurologic examination, including no clinical evidence of anisocoria or ptosis. Subsequently, a cocaine test demonstrated pharmacologic Horner's syndrome. MRI confirmed the carotid dissection. This patient illustrates that a history of transient pupillary and eyelid abnormalities can lead to the diagnosis of a carotid dissection. Specific questioning about transient anisocoria and ptosis should be considered when a carotid artery dissection is suspected. Pharmacologic testing may be a useful tool in such instances.
我们描述了一名41岁女性，基于近期持续2天的瞳孔不等大和同侧上睑下垂病史，怀疑其患有颈动脉夹层。她的神经系统检查正常，包括没有瞳孔不等大或上睑下垂的临床证据。随后，可卡因试验证实为药物性霍纳综合征。MRI证实了颈动脉夹层。该患者表明，短暂的瞳孔和眼睑异常病史可导致颈动脉夹层的诊断。当怀疑有颈动脉夹层时，应考虑对短暂性瞳孔不等大和上睑下垂进行特异性询问。在这种情况下，药物试验可能是一种有用的工具。
