Raeder's syndrome. Report of two cases

Raeder's syndrome constitutes facial pain and ipsilateral stenosis of the palpebral fissure, miosis and enophthalmos. It is divided into two groups. Group I includes cases with parasellar cranial nerve involvement and group II without parasellar cranial nerve involvement. It is often difficult to distinguish group II of Raeder's syndrome from Horner's syndrome. The latter is painless and is accompanied by anidrosis of the ipsilateral half of the face. In fact Raeder's syndrome may be caused by any lesion affecting the post-ganglionic oculosympathetic fibers distal to the bifurcation of the common carotid artery. Serious lesions of the internal carotid artery (ICA) may be responsible for this syndrome. This paper deals with two cases of group II of Raeder's syndrome. In the first case, a 60-year-old man, the angiogram revealed an aneurysm of the extracranial part of the ICA just below its entrance into the calvarium. In the second case, a 42-year-old man, a dissective aneurysm of the ICA was found. Surgery was not attempted in either of our patients for different reasons. Their symptoms ameliorated quickly with medical treatment.