Claude Bernard-Horner Syndrome Research Articles

Alimentary tract duplications in children - a 15 years' experience.

Duplications of the alimentary tract are a diverse and complex spectrum of congenital malformations and can be found anywhere along the digestive tract. The management depends on multiple factors, such as age, location, size, macroscopic aspect, and the associated anomalies. This study reflects a 15-year single surgical team experience. We reviewed medical records of 35 consecutive patients presenting alimentary tract duplications, evaluated and managed between 2004 and 2019. The anatomical distribution included: oral structures (two cases), esophageal (three cases), gastric (three patients), jejunoileal (seven cases), ileocecal (12 cases), colonic (six cases), anorectal (one case), and one case of complex tubular duplication of the terminal ileum and entire colon with two anal openings at the perineum. Four patients had antenatal diagnosis, initially asymptomatic, were followed, after birth, with repeated ultrasound examinations for a medium period of 3.8 months. All cases were managed with open surgery. Excision of the lesion with preservation of the gut integrity could be performed in 28 of the cases, while in six cases, enterectomy followed by digestive anastomosis was required. In one complex caudal duplication syndrome, the duplicated tubular colon was left in place. The postoperative complications were gastroesophageal reflux disease (GERD) (two cases), Claude Bernard–Horner syndrome (one case), wound infection (one case), and in one case, massive tongue edema. Clinical findings may be misleading, imaging studies may be uncertain, therefore the surgeon remains to complete de picture with intraoperative findings. In complex duplication cases, a multidisciplinary approach is imperative for the best results.

Lymphome de la zone marginale ganglionnaire associé à des cellules de Reed-Sternberg : un challenge pour le pathologiste

We report the case of a 46-year-old male patient presenting with a Claude Bernard-Horner Syndrome. Clinical evaluation showed a clonal B-cell population, lambda restricted. PET-scan captured femoral and axillary lymph nodes. Therefore the diagnosis of a marginal zone lymphoma was posted for which an attitude of watchful waiting was suggested. Eighteen months later, the patient developed an inguinal adenopathy. This lymph node led to the diagnosis of a nodular sclerosing Hodgkin lymphoma. Initial treatment with ABVD showed a good response, but the patient relapsed after eight months. A second biopsy confirmed the diagnosis of a marginal zone lymphoma but also identified giant Reed-Sternberg cells, (CD15+, CD30+ and CD20+). The initial biopsy was revised. This last diagnosis of a nodal marginal zone lymphoma with presence of Reed-Sternberg cells is rarely described in the literature. Several scientific theories can be found. Some cases described a transformation of non-Hodgkin lymphoma that presented Reed-Sternberg cells, other cases mentioned a collision or composite tumor. An accidental finding of Reed-Sternberg cells can be seen by after an infectious disease such as EBV. The presence of only Reed-Sternberg cells in a non-Hodgkin lymphoma is not sufficient to make a diagnosis of collision tumor.

Functional Results of Cervical Rib Resection for Thoracic Outlet Syndrome: Impact on Professional Activity

The aim of this study is to report long-term functional results following cervical rib (CR) resection for thoracic outlet syndrome (TOS). This monocentric study included all cases of resection of CR for TOS performed between January 2004 and December 2016. Data were retrospectively collected from the hospital electronic database including preoperative symptoms and the evaluation of occupational well-being, intraoperative data, and early clinical evaluation and occupational well-being during the postoperative period. Patients were categorized as neurogenic TOS (NTOS), arterial TOS (ATOS), arterial and neurogenic TOS (ANTOS), venous TOS (VTOS), or asymptomatic according to preoperative evaluation. We evaluated the improvement in work life between the preoperative and the postoperative period. Further assessment was a negative Roos or elevated arm stress test (EAST) during the postoperative period. Thirty-three patients with a median age of 38.5years (30-46) were included. Thirty-six procedures were performed: 33% to treat ATOS (12/36), 39% for NTOS (14/36), 19% for ANTOS (7/36), 3% for VTOS (1/36), and 6% (2/36) for asymptomatic lesions. There were 9 cases of subclavian artery aneurysms leading to additional arterial repair. Due to distal embolization, a cervical sympathectomy was associated in 5 procedures. First rib resection was associated in 4 procedures (11%) and C7 transverse process resection was performed in 15 procedures (42%). The technical success rate was 100% and intraoperative complications were observed in 4 patients (11%) with favorable postoperative outcomes. During the early postoperative period, 3 Claude Bernard-Horner's syndrome and 1 asymptomatic subclavian dissection were detected. Late complications included 2 bypass thromboses (6%) at 6weeks and 16months. Postoperative EAST improved in 16 limbs (44%). Prior to the procedure, only 27% (9/33) patients had normal work lives. After the procedure, 64% (21/33) of patients were able to return to their normal work activity. CR resection for TOS seems to be a safe procedure leading to good short- and long-term clinical results with a favorable impact on recovering a normal work life in these young patients.

Claude Bernard-Horner Syndrome Caused by Jugular Vein Cannulation for Chronic Hemodialysis

Claude Bernard-Horner Syndrome Caused by Jugular Vein Cannulation for Chronic Hemodialysis

Lagrimeo de ojo derecho tras tos y estornudo

This is a 59-year old Caucasian male patient, dislipidemic, who came to a scheduled visit to his medical practitioner for monitoring of his dislipidemia. In the medical anamnesis on his general health condition, the patient reported tearing of his right eye and mild headache in the right hemicranial region, after a cold with cough and sneezing. Initially, anisocoria was initially observed. In the urgent cranial X-ray, there was an image consistent with right orbital space occupation. After performing the corresponding complementary tests, the diagnosis was made of Claude Bernard-Horner syndrome secondary to right carotid dissection, which was not susceptible to surgical treatment. The patient has had good posterior evolution.

Síndrome de Claude Bernard-Horner associada ao empiema pleural

Claude Bernard-Horner syndrome presents various etiologies and occurs as the direct result of interrupted nerve signaling at any point along the nerve trajectory, be it intrathoracic or extrathoracic. Herein, we report a case of Claude Bernard-Horner syndrome caused by loculated pleural empyema located in the paravertebral region of the upper third of the right hemithorax. The patient was submitted to thoracotomy in order to drain the infected fluids. The end result was satisfactory, including resolution of the infection, pulmonary expansion, and remission of the syndrome.

Carcinomes différenciés de la thyroïdeavec envahissement laryngo-trachéal

Analyze the diagnosis and treatment of differentiated thyroid carcinomas with laryngo-tracheal invasion. Among the 117 patients operated for a differentiated thyroid carcinoma in the ENT department of Tours Hospital (France) between January 1990 and December 2003, seven presented laryngo-tracheal invasion and were included in this retrospective study. Laryngo-tracheal resection resulted in a thyroid cartilage-shaving in two patients. We performed a resection of one side of the thyroid cartilage in one patient, a thyro-tracheal resection-anastomosis with a partial cricoidectomy in one patient, a partial vertical laryngectomy extended to the first tracheal ring in one patient and a total laryngectomy in one patient. No laryngo-tracheal resection was done in one patient. Early complications were swallowing disorders (n = 2), transitory hypoparathyroidism (n = 1), definitive recurrent nerve paralysis (n = 2), subcutaneous emphysema and hematoma (n = 1) and Claude Bernard-Horner's syndrome (n = 1). Locoregional recurrences (n = 2) and distant metastasis (n = 2) were discovered six months to four years after the laryngo-tracheal resection. With a mean follow-up of 40 month, four patients were alive (two disease free) two patients had died and one was lost of follow-up at three months. The frequency of locoregional recurrences and distant metastasis is higher for the differentiated thyroid carcinomas with laryngo-tracheal invasion than the others. In these cases, we performed macroscopic carcinological surgery preserving laryngeal functions as much as possible.

Polyradiculonévrite inflammatoire démyélinisante chronique et atteinte du système nerveux autonome

Involvement of the autonomic nervous system during Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) is rare. Localised hyperhydrosis and Claude Bernard Horner (CBH) syndrome have never been reported in patients with CIDP. We report the case of a 65-year-old right handed man who presented with hyperhydrosis localised to the right hemithorax and hemiface and a left CBH syndrome. After an extensive workup, the patient was found to have CIDP as the only cause of autonomic nervous system involvement. The symptoms resolved slowly after three courses of intravenous immunoglobulins. Signs of autonomic nervous system involvement can be observed in CIDP as in Guillain-Barré syndrome. This case report shows that immunomodulatory treatment can be effective against dysautonomia in CIDP.

Le syndrome de Pourfour du Petit : une cause rare d’exophtalmie unilatérale avec mydriase et élargissement de la fente palpébrale

Introduction. – Pourfour du Petit syndrome, rarely reported, is the opposite of Claude Bernard-Horner syndrome. Exegesis. – A 67 years old female is hospitalised for dysphagia, allowing the discovery of oesophagus carcinoma with mediastinal, pleural and costal extension. The discovery of left unilateral mydriasis associated with exophthalmos and eyelid retraction suggest Pourfour du Petit syndrome ; this diagnosis is confirmed by CT-scan, finding pedicular lysis of high dorsal vertebras and intra-canalar tumoral extension. Conclusion. – Pourfour du Petit syndrome has the same localisation value and the same aetiologies as Claude Bernard-Horner syndrome, but its mechanism proceeds byan exciting lesion of cervical sympathetic nervous system. The recognition of this entity can allow the diagnosis of pathologies that need emergency treatment.

Primary pediatric neuroblastic tumors of the neck

Neuroblastic tumors are the third most common cause of solid tumors in early childhood. Cervical tumors account for only 5% of cases. In this report, we describe a series of four pediatric neuroblastic tumors of the neck. The histological diagnosis was ganglioneuroblastoma in three cases and neuroblastoma in one case. Presenting signs were solitary cervical mass in two cases and respiratory distress in association with Claude-Bernard Horner's syndrome in two cases. Mean age at presentation was 15 months. Cervical computed tomography scan and/or magnetic resonance imaging depicted calcifications within the tumor in 50% of cases and allowed accurate assessment of extension. Increased urine catecholamine levels were observed only in the patient with neuroblastoma. Scintigraphy with [131]iodine-methyliodobenzylguanidine demonstrated selective uptake by the tumor in two cases. Amplification of N-myc oncogene, a documented unfavorable prognostic sign, was not found in any case. Surgical treatment was performed in all patients. Neoadjuvant chemotherapy was performed in one case. All patients underwent regular surveillance. No evidence of recurrence has been observed with a mean follow-up period of 7 years.

Neurovegetative Störungen bei 230 Fällen basilärer Impression und Arnold-Chiarischer Mißbildung

Within the period of 1971 to 1989 we operated on 230 cases of craniocervical malformations characterised by 189 cases of basilar impression associated with Arnold-chiari malformation, 28 cases of isolated basilar impression and 13 cases of Arnold-Chiari malformation. Autonomic disturbance was observed in 136 (59.1%) cases: sexual disorders like reduced potency and impotency were observed in 86 (60.9%) out of 141 male patients, urinary symptoms in 39 (17%) patients; and other autonomic features like dyspnea, anhidrosis, hyperhidrosis, Claude Bernard-Horner syndrome and constipation in 41 (17.8%) patients.

Carcinoma of the superior pulmonary sulcus

Fifty-six patients with superior sulcus syndrome were evaluated at the First Surgical Department of the University of Padua between 1981 and 1990. Forty-two patients with the characteristic of Pancoast's tumor received preoperative irradiation and then en bloc resection of the tumor, chest wall, and adjacent structures. Seven lobectomies and 35 segmentectomies or wedge resections were performed. There was one early postoperative death. Median survival was 14 months, and actuarial survival was 25% at 5 years. Patients with pain relief had better 5-year survival (36.4%) than patients without pain relief (9%). We have no patients with vertebral invasion who survived more than 1 year. Of the five patients with subclavian artery invasion, only one survived more than 1 year. Of five patients with N2 disease, only one survived more than 1 year. Our results suggest that pain relief after irradiation is a good prognostic factor, whereas N2 involvement and vertebral body and great vessel invasion are ominous factors. Another ominous prognostic factor is the Claude Bernard-Horner syndrome even if it is not a contraindication to resection.

HORNER AND THE SYNDROME OF PARALYSIS OF THE CERVICAL SYMPATHETIC

In recent years, experimental and clinical neurology have become mutually dependent, and it is refreshing to record an early phase of their association. The theme, too, is a fitting one, since he whom we wish to honor has devoted himself equally to the laboratory and the clinic—to the great benefit of both. The shrewd clinical observations of Horner are, moreover, strongly reminiscent of the "Chief," being painstaking, accurate and far-seeing. The symptom-complex known variously as the Claude Bernard-Horner syndrome (in France), Budge's phenomenon (among physiologists), but usually and more rightly as Horner's syndrome, is characterized by sinking-in of the eyeball (enophthalmos), narrowing of the palpebral fissure, drooping of the upper lid and slight elevation of the lower, constriction of the pupil, and by certain anomalies in vasomotor and sudorific activity of the neck and face. It is seen in traumatic injuries of the cervical spine, in tumors of the spinal

Frequency of the Claude Bernard-Horner Syndrome: Report of Sixteen Cases

In sixteen cases encountered over a period of four years, enophthalmos, ptosis, and narrowing of the palpebral fissure were present without exception; and miosis was present in all except one case. Hypotony was present in over a third of the cases, heterochromia in two cases. The etiology of the sympathetic paralysis was determined in only one case, in which it was syringomyelia. Read before the American Ophthalmological Society, May, 1928.

A REPORT OF ELEVEN CASES OF CERVICAL SYMPATHETIC NERVE INJURY, CAUSING THE OCULOPUPILLARY SYNDROME

The report of the following series of cervical sympathetic nerve lesions, due to gunshot wounds, observed in the U. S. Army General Hospital No. 11, was prompted by the comparatively large number coming under our care at one time, and by the relatively few cases noted in military literature to date. It may be that more such cases have not been recorded during the present war, first, because in the stress of work they were overlooked; secondly, because of their slightly defined symptoms; and lastly, because it is possible that no evidence of a Claude Bernard-Horner syndrome appeared until some weeks or months after injury, the patients by that time having passed from under medical supervision. Our patients, on the other hand, had in some instances been wounded from six to nine months before admission to the hospital, and sufficient time had elapsed for symptoms to develop. Then too, we