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Erschienen in:
22.02.2016 | Clinical Practice: Clinical Images
Raeder’s Paratrigeminal Syndrome: Headache and Horner’s Lacking Anhidrosis
Erschienen in: Journal of General Internal Medicine | Ausgabe 9/2016
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A 61-year-old man with alcoholic cirrhosis, hepatocellular carcinoma, and a smoking history presented with 3 months of blurred vision, periorbital headache and 10-pound weight loss. On exam, he had left-sided ptosis, miosis (Fig. 1) and diminished sensation in the left ophthalmic trigeminal nerve distribution. Computed tomography (CT) revealed a 1.5 × 2.0 × 3.0 cm parapharyngeal mass encasing the left internal carotid artery (ICA) with significant narrowing; however, no dissection (Fig. 2). A CT-guided biopsy showed inflammation and no malignant cells. Aspirate cultures were negative. The etiology was inconclusive, but strongly favored malignancy.
Figure 1.
Left-sided ptosis and miosis with a right pupil size of 5 mm compared to 2 mm on the left. He had diminished sensation in the left V1 distribution.
Figure 2.
Contrast-enhanced CT scan of the neck showing a parapharyngeal mass (blue arrow) causing narrowing of the internal carotid artery.
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