Neurology:Horner综合征热成像1例

2019-10-25 zyx 神经科病例撷英拾粹

50岁女性,既往有肌纤维发育不良病史,因右耳疼痛1天至急诊。查体提示瞳孔不等大,左侧瞳孔较右侧瞳孔大2mm,双侧瞳孔对光反应灵敏;右侧上睑下垂2.5mm;右侧前额无汗。

50岁女性,既往有肌纤维发育不良病史,因右耳疼痛1天至急诊。查体提示瞳孔不等大,左侧瞳孔较右侧瞳孔大2mm,双侧瞳孔对光反应灵敏;右侧上睑下垂2.5mm;右侧前额无汗。热成像与查体结果相符(图)。患者被诊断为急性痛性Horner综合征。MRI/MRA可见右侧颈内动脉夹层。由于颈内动脉夹层有立即出现卒中的风险,患者接受肝素注射,随后改为阿司匹林和氯吡格雷联合治疗。


(图:症状出现后2月用FLIROne相机获得的热成像图片,可见右侧前额温度降低;符合右侧三级[third-order]Horner综合征,因继发于去交感神经支配的肾上腺素能超敏反应延迟出现,导致受累区域血管收缩)

原始出处:Henderson AD, Ramulu PY, Lawler JF.Teaching NeuroImages: Thermal imaging in Horner syndrome.Neurology. 2019 Sep 24;93(13):e1324-e1325.

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