J Korean Ophthalmol Soc.  2022 May;63(5):490-494. 10.3341/jkos.2022.63.5.490.

Central Horner Syndrome with Vertebral Artery Dissection

• Park YM
• Kim HY

• KMID: 2530265
• DOI: http://doi.org/10.3341/jkos.2022.63.5.490

Abstract

Purpose
To report the first case of a 53-year-old male patient diagnosed with central Horner syndrome, associated with vertebral artery dissection, which has never been reported in Korea to date.
Case summary
A 53-year-old male patient presented with conjunctival hyperemia in the left eye for over 4 months, with a past history of acute subarachnoid hemorrhage and ruptured dissecting aneurysm in the left vertebral artery. On slit-lamp examination, mild ptosis of the upper eyelid and conjunctival hyperemia were noted in his left eye. The left pupil was smaller than the right without afferent pupillary defects in either eye. Anisocoria was greater in the dark, and dilation lag was noted in the left pupil. On systemic examination, he complained of numbness in the right upper and lower extremities and symptoms of leaning to the left when walking. After instillation of 0.5% apraclonidine, the anisocoria was reversed, and ptosis and conjunctival hyperemia disappeared. Magnetic resonance images revealed chronic infarction in the left lateral medulla, and he was diagnosed with central Horner syndrome associated with Wallenberg syndrome.
Conclusions
We present the first case in Korea of central Horner syndrome associated with lateral medullary infarction caused by vertebral artery dissection.

Keyword

Central Horner syndrome; Lateral medullary infarction; Vertebral artery dissection; Wallenberg syndrome