A. Internal carotid aneurysm – Explanation
Horner’s syndrome – anhydrosis determines site of lesion:
|
Horner’s syndrome
Features
- miosis (small pupil)
- ptosis
- enophthalmos* (sunken eye)
- anhydrosis (loss of sweating one side)
Distinguishing between causes
- heterochromia (difference in iris colour) is seen in congenital Horner’s
- anhydrosis: see below
| Central lesions | Pre-ganglionic lesions | Post-ganglionic lesions |
| Anhydrosis of the face, arm and trunk | Anhydrosis of the face | No anhydrosis |
| Stroke
Syringomyelia Multiple sclerosis Tumour Encephalitis |
Pancoast’s tumour
Thyroidectomy Trauma Cervical rib |
Carotid artery dissection
Carotid aneurysm Cavernous sinus thrombosis Cluster headache |
*in reality the appearance is due to a narrow palpebral aperture rather than true enophthalmos
