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Painful Horner syndrome

¹ Department of Vascular Surgery, Mayday University Hospital, Croydon, UK
² Department of Radiology, Mayday University Hospital, Croydon, UK

Correspondence to:
Mr P Wilkerson, Department of Vascular Surgery, Mayday University Hospital, Croydon CR7 7YE, UK; pmwilkerson@doctors.org.uk

Submitted 7 October 2007
Accepted 23 January 2008

The first 150 words of the full text of this article appear below.

A 57-year-old hypertensive woman presented with a sudden onset of left sided facial pain. Clinical examination revealed a left sided Horner syndrome only. Magnetic resonance imaging (MRI) demonstrated abnormal signal in relation to the left internal carotid artery (ICA) extending into the petrous segment, consistent with ICA dissection (fig 1). She was treated with warfarin for 6 months. Her facial pain subsided and the Horner syndrome reduced considerably. Follow-up MRI at 3 months showed recanalisation of the ICA, and she was asymptomatic at 3 years follow-up.

View larger version (64K):   Figure 1 Double echo TL weighted MRI sections taken above the level of the dissection (horizontal petrous portion of the internal carotid artery), at the level of the dissection and 2 cm below it. Normal flow void is seen above and below the lesion, which is represented by a crescenteric high signal area.