Horner's Syndrome: A Complication Following Carotid Endarterectomy

Abstract

Extracranial nerve injury following carotid endarterectomy (CEA) has been the subject of numerous reports. Horner's syndrome has been associated with a number of disorders of carotid artery but has not been reported in the literature following CEA. Horner's syndrome is characterized by specific neurologic and ophthalmologic findings and has been associated with carotid artery dissection, occlusion, aneurysm, fibromuscular dysplasia, and carotid body tumor. The authors report a persistent ipsilateral Horner's syndrome that developed in a sixty-four-year-old woman following CEA. Since 1977, 290 CEAs have been performed by the authors, and this is the only instance of this complication. The anatomy of the sympathetic chain and a review of Horner's syndrome are pre sented. Several possible etiologies are proposed for this oculosympathetic defect following CEA.