title: Horner syndrome and VI nerve paresis as a diagnostic clue to a hidden lesion.
abstract: A 33-year-old man treated elsewhere for an isolated VI cranial nerve paresis underwent an attempted transnasal biopsy of a large space-occupying lesion in the cavernous sinus and petrous apex seen on a CT scan. During the procedure, he developed severe bleeding and hypovolaemic shock. When he came to us 2 years later, he had Homer syndrome along with a mild VI nerve paresis that aided in localizing the lesion to the carotid canal and the posterior cavernous sinus. Digital subtraction angiography revealed a large internal carotid artery aneurysm of the laceral and petrous segments within the carotid canal, mushrooming into the posterior cavernous sinus.
authors.affiliation: Schell Eye Hospital, Arni Road, Christian Medical College and Hospital, Vellore 632001, Tamil Nadu, India. jeyanthrose@hotmailcom
authors.forename: Jeyanth
authors.initials: J
authors.lastname: Rose
authors.forename: Pushpa
authors.initials: P
authors.lastname: Jacob
authors.forename: Tripti
authors.initials: T
authors.lastname: Jacob
mesh_terms: D000010:Abducens Nerve; D000328:Adult; D015901:Angiography, Digital Subtraction; D002340:Carotid Artery Diseases / Q000175:diagnosis*; D003389:Cranial Nerve Diseases / Q000175:diagnosis*; D003937:Diagnosis, Differential; D006732:Horner Syndrome / Q000175:diagnosis*; D006801:Humans; D002532:Intracranial Aneurysm / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging; D008297:Male; D014057:Tomography, X-Ray Computed