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Silva L, Junqueira AF, Pato R, Farraposo S, Cruz AR, Rocha T. Horner's Syndrome as a Complication of Ultrasound-Guided Central Cannulation: A Case Report. Cureus 2022; 14:e28700. [PMID: 36204040 PMCID: PMC9527068 DOI: 10.7759/cureus.28700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2022] [Indexed: 11/05/2022] Open
Abstract
Cannulation of the internal jugular vein is often necessary for the management of critically ill patients. Despite being a very common procedure and performed more and more safely, several complications still occur. Horner's Syndrome (HS) is one of those complications described before the use of ultrasound as a method of guidance. HS is caused by functional interruption of sympathetic nerve supply to the eye, leading to a classic triad of ipsilateral ptosis, miosis, and anhidrosis. We present the case of a patient, in need of emergent surgery to control the hemorrhagic focus after delivery, with a transient HS secondary to internal jugular vein cannulation under real-time ultrasound guidance.
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Zou Z, Yao Y. Horner Syndrome Caused by Internal Jugular Vein Catheterization. J Cardiothorac Vasc Anesth 2020; 34:1636-1640. [DOI: 10.1053/j.jvca.2019.06.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 05/29/2019] [Accepted: 06/19/2019] [Indexed: 11/11/2022]
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Loewenthal J, Patel A, Kurtz R, Piazza G. Images in Vascular Medicine: A case of Horner's syndrome after catheter-based fibrinolysis for pulmonary embolism. Vasc Med 2018; 23:489-490. [PMID: 29775165 DOI: 10.1177/1358863x18769151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Julia Loewenthal
- 1 Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Ankit Patel
- 1 Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Robert Kurtz
- 2 Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Gregory Piazza
- 3 Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
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Vinod KV, Sivabal V, Vidya MV. Iatrogenic Horner's syndrome: A cause for diagnostic confusion in the emergency department. World J Emerg Med 2017; 8:235-236. [PMID: 28680524 DOI: 10.5847/wjem.j.1920-8642.2017.03.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Kolar Vishwanath Vinod
- Department of General Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Dhanvantrinagar, Puducherry, Pondicherry 605006, India
| | - Vanjiappan Sivabal
- Department of General Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Dhanvantrinagar, Puducherry, Pondicherry 605006, India
| | - Mysore Venkatakrishna Vidya
- Department of Anesthesiology and Critical Care, Jawaharlal Institute of Postgraduate Medical Education and Research, Dhanvantrinagar, Puducherry, Pondicherry 605006, India
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Lee MS, Suh YJ, Suk EH, Park CH. Painful Horner syndrome after thyroidectomy −A case report−. Anesth Pain Med (Seoul) 2016. [DOI: 10.17085/apm.2016.11.3.313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Myung Su Lee
- Department of Anesthesiology and Pain Medicine, Kwangju Christian Hospital, Gwangju, Korea
| | - Young Joong Suh
- Department of Anesthesiology and Pain Medicine, Kwangju Christian Hospital, Gwangju, Korea
| | - Eun Ha Suk
- Department of Anesthesiology and Pain Medicine, Kwangju Christian Hospital, Gwangju, Korea
| | - Cheon Hee Park
- Department of Anesthesiology and Pain Medicine, Kwangju Christian Hospital, Gwangju, Korea
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Butty Z, Gopwani J, Mehta S, Margolin E. Horner's syndrome in patients admitted to the intensive care unit that have undergone central venous catheterization: a prospective study. Eye (Lond) 2015; 30:31-3. [PMID: 26381100 DOI: 10.1038/eye.2015.181] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Accepted: 07/20/2015] [Indexed: 11/09/2022] Open
Abstract
PurposeCentral venous catheterization (CVC) is estimated to be performed in millions of patients per year. Swan-Ganz catheters used for CVC are most often inserted into the internal jugular vein and during this procedure they may come into contact with the sympathetic chain. This study aims to determine the incidence of Horner's syndrome in patients admitted to intensive care unit that have undergone internal jugular CVC insertion during their admission and to determine whether ultrasonography-assisted insertion has decreased the frequency of this complication.Patients and methodsA total of 100 prospective patients admitted to the ICU were examined for the presence of anisocoria and ptosis after undergoing recent CVC. Presence of Horner's syndrome was confirmed by testing with 0.5% apraclonidine and looking for the reversal of anisocoria.ResultsFrequency of Horner's syndrome after CVC was 2% in a sample of 100 prospectively examined patients.ConclusionHorner's syndrome remains a relatively rare but definitive complication of CVC. ICU physicians should be educated about its existence and prevalence and ophthalmologists should inquire about any history of ICU admission necessitating CVC insertion in any patient presenting with Horner's syndrome.
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Affiliation(s)
- Z Butty
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
| | - J Gopwani
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.,Department of Ophthalmology, University of West Indies, Kingston, Jamaica
| | - S Mehta
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - E Margolin
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.,Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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Chan CC, Lee V, Chu W, Tam YH, Li CK, Shing MMK. Carotid jugular arteriovenous fistula: an unusual complication of internal jugular vein catheterization in children. Pediatr Blood Cancer 2012; 59:1302-4. [PMID: 22415906 DOI: 10.1002/pbc.24137] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2011] [Accepted: 02/21/2012] [Indexed: 11/08/2022]
Abstract
Central venous catheterization is essential in the management of patients requiring long-term intravenous access. Various risks during central line insertion have been described in the medical literature, including the potentially life-threatening complication of iatrogenic arteriovenous fistula (AVF). We describe a novel case of carotid jugular AVF following implanted port (BardPort® by C.R. Bard, Inc.) insertion in a pediatric oncology patient who had suffered cerebral infarct due to thromboembolism. Pediatr Blood Cancer 2012; 59: 1302-1304. © 2012 Wiley Periodicals, Inc.
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Affiliation(s)
- Ching Ching Chan
- Department of Pediatrics, Lady Pao Children's Cancer Centre, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, NT, Hong Kong
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Relaño Cobián T, Muñoz Alameda LE, López Pérez V, Del Olmo Falcones M. [Asystole due to compression of the carotid sinus after accidental puncture of the internal carotid artery]. REVISTA ESPANOLA DE ANESTESIOLOGIA Y REANIMACION 2010; 57:255. [PMID: 20499809 DOI: 10.1016/s0034-9356(10)70218-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
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Jo YJ, Lee YH, Yun YJ, Lee SB. Iatrogenic Horner's Syndrome After Procedure in the Neck and Upper Thoracic Area. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2009. [DOI: 10.3341/jkos.2009.50.6.809] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Young Joon Jo
- Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Korea
- Research Institute for Medical Science, Chungnam National University College of Medicine, Daejeon, Korea
| | - Yeon Hee Lee
- Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Korea
- Research Institute for Medical Science, Chungnam National University College of Medicine, Daejeon, Korea
| | - Yong Jun Yun
- Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Korea
| | - Sung Bok Lee
- Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Korea
- Research Institute for Medical Science, Chungnam National University College of Medicine, Daejeon, Korea
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Suominen PK, Korhonen AM, Vaida SJ, Hiller AS. Horner's syndrome secondary to internal jugular venous cannulation. J Clin Anesth 2008; 20:304-6. [PMID: 18617132 DOI: 10.1016/j.jclinane.2007.10.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2007] [Revised: 10/01/2007] [Accepted: 10/25/2007] [Indexed: 10/21/2022]
Abstract
Horner's syndrome is a rare complication following insertion of a central catheter into the internal jugular vein (IJV). A 5-year-old boy, who developed unilateral Horner's syndrome postoperatively following IJV cannulation, is presented. The Horner's syndrome resolved completely after 5 months.
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Affiliation(s)
- Pertti K Suominen
- Department of Anaesthesia and Intensive Care, Hospital for Children and Adolescents, Helsinki University Central Hospital, FIN-00029 HUS, Helsinki, Finland.
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Links DJR, Crowe PJ. Horner's syndrome after placement of a peripherally inserted central catheter. JPEN J Parenter Enteral Nutr 2006; 30:451-2. [PMID: 16931616 DOI: 10.1177/0148607106030005451] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We describe a delayed case of Horner's syndrome after the use of a peripherally inserted central line. Central vein thrombosis, a well-recognized complication of central venous access, led to temporary injury to the sympathetic tract in the neck. Presentation of Horner's syndrome with central venous access in place should be further investigated to rule out central vein thrombosis.
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Batjom E, Ball A, Mercier F, Benhamou D. Syndrome de Claude-Bernard-Horner consécutif à la pose d'un cathéter veineux jugulaire interne. ACTA ACUST UNITED AC 2006; 25:662-3. [PMID: 16581220 DOI: 10.1016/j.annfar.2006.02.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Doğan E, Erkoç R, Sayarlıoğlu H, Etlik Ö, Uzun K. A Rare Complicatıon of Internal Jugular Vein cannulatıon: horner's syndrome. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2005. [DOI: 10.29333/ejgm/82336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Mastan M. Carotid artery pseudoaneurysm with Horner's syndrome: delayed complication of internal jugular venous cannulation. Br J Hosp Med (Lond) 2005; 66:314-5. [PMID: 15920868 DOI: 10.12968/hmed.2005.66.5.18432] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- M Mastan
- Department of Anaesthesia, Rochdale Infirmary, Rochdale, Lancashire OL12 0NB
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Williams MA, McAvoy C, Sharkey JA. Horner's syndrome following attempted internal jugular venous cannulation. Eye (Lond) 2004; 18:104-6. [PMID: 14707988 DOI: 10.1038/sj.eye.6700547] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Aronson LA, Parker GC, Valley R, Norfleet EA. Acute Horner syndrome due to thoracic epidural analgesia in a paediatric patient. Paediatr Anaesth 2000; 10:89-91. [PMID: 10632916 DOI: 10.1046/j.1460-9592.2000.00445.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A 4-year-old boy with coarctation of the aorta underwent surgical aortic arch repair with general anaesthesia and thoracic epidural analgesia. In the immediate postoperative period, the child developed a unilateral Horner syndrome which appeared to be related to the epidural infusion rate. Management of this patient as well as alternate aetiologies of Horner syndrome are described. Horner syndrome is a rare complication of epidural catheters and is often unrecognized, especially in children.
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Affiliation(s)
- L A Aronson
- Department of Anaesthesiology, The University of North Carolina at Chapel Hill, USA
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Ségura P, Speeg-Schatz C, Wagner JM, Kern O. [Claude Bernard-Horner syndrome and its opposite, Pourfour du Petit syndrome, in anesthesia and intensive care]. ANNALES FRANCAISES D'ANESTHESIE ET DE REANIMATION 1998; 17:709-24. [PMID: 9750809 DOI: 10.1016/s0750-7658(98)80108-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To analyse cases of Horner's syndrome (HS) and its opposite, Pourfour du Petit's syndrome (PPS), occurring in anaesthesia and intensive therapy with consideration of the data of current literature. DATA SOURCES For this paper we have reviewed the French, English and German literature published in anaesthesia and intensive care journals using Medline search and the current textbooks. STUDY SELECTION All observational studies on these syndromes, whether clinical cases or letters to the editor, form the basis for this article. DATA EXTRACTION The articles were analysed mainly with regard to diagnosis, therapy and prognosis of syndromes due to iatrogenic causes. DATA SYNTHESIS HS is caused by a paralysis of the ipsilateral sympathetic cervical chain and includes a ptosis of the upper eyelid, a slight elevation of the lower lid, a sinking of the eyeball, a constriction of the pupil, a narowing of the palpebral fissure, a nasal stuffiness associated with anhidrosis, and flushing of the affected side of the face. Regional anaesthesia (intra-oral anaesthesia, brachial plexus block, epidural anaesthesia whether by thoracic, lumbar or caudal approach, as well as interpleural analgesia) is the main anaesthetic cause for HS. HS due to the effect of a local anaesthetic is transient, it can precede a high spinal block and a cardiovascular collapse. HS from puncture of the internal jugular vein is most often permanent. When transient, HS regresses within 3 months after puncture. Other causes of HS include intraoperative posture, pleural drain, neck surgery, neck trauma. A mydriatic collyrium, such as phenylephrine, resolves ptosis for less than 1 hour and results in blurred vision from pupillary dilation. Major ptosis requires surgery. PPS is the reciprocal HS and is caused by a stimulation of the ipsilateral sympathetic cervical chain. PPS can precede HS. It carries a risk for conjunctivitis, keratitis and epiphora in case of major exophthalmia. PPS is often reported as an unilateral mydriasis. PPS has the same causes as HS. Myotic collyriums are relatively inefficient. Major lid retraction requires a tarsorraphy, pomades and nocturnal lid occlusion. A part of HS and most PPS occurring in anaesthesia and intensive care remain unrecognized or are recognized with delay, especially if they remain minor and transient or when they occur in unconscious patients, in horizontal posture.
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Affiliation(s)
- P Ségura
- Service d'anesthésie-réanimation chirurgicale, hôpital de Hautepierre, Strasbourg, France
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