Abstract
The pathophysiology of Horner's syndrome arises due to compression or destruction of the oculosympathetic nerve pathway. Traumatic Horner's syndrome may indicate lethal neurovascular injury, such as brain stem lesion, cervical spine injury, or carotid artery dissection. The middle-third is the most common type of clavicle fracture. However, the association of the isolated middle-third clavicle fracture and Horner's syndrome is rare. We report the case of a 47 year-old woman who presented to our emergency department with acute trauma. Severe tenderness and limited mobility were observed in her left shoulder. On radiographic examination, a middle-third clavicle fracture was diagnosed. Ptosis and myosis were also noticed on further examination, and she was subsequently diagnosed with Horner's syndrome. A survey of the brain, cervical spine, carotid artery, and lung revealed no pathological findings. Surgery for the clavicle fracture was performed 2 days after the accident. The patient recovered from Horner's syndrome gradually over the 2 months following the surgery, and the syndrome completely resolved by the third month. To the best of our knowledge, this is the first report of traumatic Horner's syndrome caused by an isolated middle-third clavicle fracture. The improved outcome may be attributed to the surgical intervention for middle-third clavicle fracture, which may help release ganglion or neuronal compression.
Highlights
Horner’s syndrome is characterized by the classic triad of ipsilateral miosis, ptosis, and anhidrosis [1]
We present the diagnosis and treatment of a rare case of Horner’s syndrome caused by middle-third clavicle fracture in a motor vehicle collision, which to the best of our knowledge, is the first report of traumatic Horner’s syndrome caused by an isolated middle-third clavicle fracture
Radiography revealed a fracture of left middle-third clavicle (Figure 1A)
Summary
Horner’s syndrome is characterized by the classic triad of ipsilateral miosis, ptosis, and anhidrosis [1]. Radiography revealed a fracture of left middle-third clavicle (Figure 1A). Two days after the accident, she received surgery for open reduction and internal fixation of the clavicle fracture (Figure 1B). She denied family history of bleeding diathesis and was not taking any antithrombotic medication. Regular follow-ups in the outpatient department revealed that she recovered a full range of motion and was free of left shoulder pain at the first month post-surgery. The symptoms of Horner’s syndrome completely resolved on the third month after clavicle surgery (Figure 2B)
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
