Carotid dissection: a common cause of Horner's syndrome.
OBJECTIVE
To highlight that internal carotid artery dissection is a common cause of Horner's syndrome and that it is important to diagnose dissection as anticoagulation can prevent carotid thrombosis and embolism.


METHODS
Five case reports are presented of patients with Horner's syndrome secondary to carotid dissection. One patient had carotid dissection secondary to trauma, two had spontaneous dissections and two had dissections in the settings of other illness. A literature search was performed on carotid dissection as a cause of Horner's syndrome and its diagnosis and management.


RESULTS
The case reports and literature highlight that dissection is under-recognized as a cause of Horner's syndrome and can be missed. The investigation of choice is a magnetic resonance imaging and angiography scan of the head and neck. The treatment advocated is anticoagulation for 3-6 months.


CONCLUSIONS
Carotid dissection should be suspected in patients with Horner's syndrome, particularly if head or neck pain is present.
Chan
C C
CC
Department of Neuro-Ophthalmology, The Royal Victorian Eye and Ear Hospital, East Melbourne, Australia. chunkeng@yahoo.com
Paine
M
M
O'Day
J
J
D000925:Anticoagulants / Q000627:therapeutic use; D002343:Carotid Artery, Internal / Q000473:pathology; D020215:Carotid Artery, Internal, Dissection / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D005260:Female; D006732:Horner Syndrome / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D006801:Humans; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000175:diagnosis; D014792:Visual Acuity; D014859:Warfarin / Q000627:therapeutic use
D000925:Anticoagulants; D014859:Warfarin