Horner Syndrome

OVERVIEW

Horner Syndrome = unilateral interruption of ascending cervical sympathetic innervation eye and face.

CLINICAL FEATURES

  • History – dry eye, eye no closing, metastatic cancer, Pancoast Tumour, interscalene nerve blockade, cervical epidural
  • Examination – ptosis, miosis, anhidrosis +/- bloodshot eye +/- enopthalmos
  • Investigations – CXR, CT

CAUSES

Central Lesions

  • Brain stem CVA
  • Cervical cord lesion – trauma
  • Epidural with local anaesthetic

T1 Root Lesions

  • Pancoast Tumour (supraclavicular lung mass)
  • Traction injuries to arm
  • Aortic or subclavian artery aneurysms

Along Sympathetic Chain in Neck

  • Malignancy
  • Neck surgery
  • Carotid artery dissection
  • Lymphadenopathy

Transient

  • Regional anaesthesia – interscalene nerve block, epidural
  • Cluster headaches with migraine

CCC Neurocritical Care Series

Critical Care

Compendium

Chris is an Intensivist and ECMO specialist at The Alfred ICU, where he is Deputy Director (Education). He is a Clinical Adjunct Associate Professor at Monash University, the Lead for the  Clinician Educator Incubator programme, and a CICM First Part Examiner.

He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives. He was one of the founders of the FOAM movement (Free Open-Access Medical education) has been recognised for his contributions to education with awards from ANZICS, ANZAHPE, and ACEM.

His one great achievement is being the father of three amazing children.

On Bluesky, he is @precordialthump.bsky.social and on the site that Elon has screwed up, he is @precordialthump.

| INTENSIVE | RAGE | Resuscitology | SMACC

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