title: Brief, transient Horner's syndrome can be the hallmark of a carotid artery dissection.
abstract: 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.
authors.affiliation: Department of Neurology (Cerebrovascular Diseases), University of Iowa College of Medicine, Iowa City 52242-1053, USA.
authors.forename: E C
authors.initials: EC
authors.lastname: Leira
authors.forename: B H
authors.initials: BH
authors.lastname: Bendixen
authors.forename: R H
authors.initials: RH
authors.lastname: Kardon
authors.forename: H P
authors.initials: HP
authors.lastname: Adams
mesh_terms: D000328:Adult; D000779:Anesthetics, Local; D000784:Aortic Dissection / Q000150:complications* / Q000175:diagnosis; D015875:Anisocoria / Q000175:diagnosis; D002340:Carotid Artery Diseases / Q000150:complications* / Q000175:diagnosis; D003042:Cocaine; D005260:Female; D006732:Horner Syndrome / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D008279:Magnetic Resonance Imaging
chemical_list: D000779:Anesthetics, Local; D003042:Cocaine