Horner-Syndrom bei Karotisdissektion nach chiropraktischer Manipulation

 

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Zusammenfassung

Fallbericht: Wir berichten über einen 37-jährigen Patienten, der etwa fünf Wochen nach einer chiropraktischen Manipulation an der Halswirbelsäule über plötzliche Schmerzen der Kopfhaut rechts sowie eine engere Pupille auf derselben Seite klagte. Methoden/Ergebnisse: Durch pharmakologische Testung der Pupillen wurde ein postganglionäres Horner-Syndrom rechts nachgewiesen, das kernspintomographisch auf eine ipsilaterale Karotisdissektion im subakuten Stadium zurückgeführt werden konnte. Schlussfolgerung: Der vorliegende Fall legt einen ursächlichen Zusammenhang von Karotisdissektion und chiropraktischer Manipulation der Halswirbelsäule nahe. Dem Augenbefund kam die entscheidende Bedeutung bei der Erkennung dieser Behandlungskomplikation zu.

Abstract

Case report: We report on a 37-year old patient with sudden onset of pain of the right scalp and an ipsilateral small pupil, presenting five weeks after chiropractic manipulation of the neck. Methods/Results: Pharmacologic pupil testing showed a postganglionic Horner's syndrome on the right side. Magnetic resonance angiography confirmed the diagnosis of a dissection of the right internal carotid artery at a subacute stage. Conclusion: There appears to be a causal relationship between carotid artery dissection and the chiropractic manipulation of the cervical spine. Ophthalmological signs played the key role in detecting this complication.

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Dr. med. Daphne Gamer

Universitäts-Augenklinik Tübingen · Abteilung für Pathophysiologie des Sehens und Neuroophthalmologie

Schleichstraße 12

72076 Tübingen

Email: daphne.gamer@med.uni-tuebingen.de