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Two neuro-ophthalmic episodes separated in time and space
R D Cullom1, M E Cullom, R Kardon
1Department of the Navy, Portsmouth Naval Medical Center, Virginia, USA.
Survey of Ophthalmology
|November 1, 1995
Summary
A carotid artery dissection caused Horner
Area of Science:
- Ophthalmology
- Neurology
- Vascular Surgery
Background:
- Central retinal artery occlusion (CRAO) can be a sign of underlying carotid artery disease.
- Horner's syndrome, characterized by ptosis, miosis, and anhidrosis, can indicate neurological compromise.
- Carotid artery dissection is a critical condition that can lead to stroke and other vascular events.
Observation:
- A 46-year-old woman presented with acute Horner's syndrome and ocular pain.
- She had a history of a spontaneously resolving central retinal artery occlusion.
- Magnetic resonance angiography revealed a right internal carotid artery dissection.
Findings:
- The internal carotid artery dissection was diagnosed via magnetic resonance angiography.
- The patient's condition improved with anticoagulation therapy.
- Connective tissue disorders such as Marfan syndrome and Ehlers-Danlos syndrome were ruled out.
Implications:
- Carotid artery dissection should be considered in patients presenting with Horner's syndrome, especially with a history of retinal artery occlusion.
- Prompt diagnosis and anticoagulation can lead to favorable outcomes in carotid artery dissection.
- This case highlights the importance of vascular imaging in evaluating neurological and ophthalmological symptoms.