American Journal of Neuroradiology 24:1508-1511, September 2003
© 2003 American Society of Neuroradiology
INTERVENTIONAL
Horner Syndrome Related to Ipsilateral Carotid Wall Hematoma after Stent Placement for the Treatment of Carotid Stenoses
a Department of Neurology, Universitaetsklinikum Hamburg-Eppendorf, Germany
b Department of Neuroradiology, Universitaetsklinikum Hamburg-Eppendorf, Germany
Address reprint requests to Dr Michael Rosenkranz, Department of Neurology, Universitaetsklinikum Hamburg-Eppendorf, Martinistrasse 52, D-20246 Hamburg, Germany
BACKGROUND AND PURPOSE: We prospectively studied the incidence and natural history of Horner syndrome following stent-supported percutaneous angioplasty of the carotid artery (SPAC). We assessed the hypothesis that postinterventional Horner syndrome is related to ipsilateral carotid wall hematoma.
METHODS: We performed duplex sonography of the carotid arteries and clinical examination in 28 consecutive patients before and 4 hours ± 2, 24 hours ± 2, and 7 days ± 1 after SPAC.
RESULTS: Within 24 hours ± 2 after SPAC, 11 of the 28 patients developed ipsilateral Horner syndrome. Ten of these 11 patients had a postinterventional sonographic appearance of a carotid wall hematoma, whereas only two of the 17 patients without Horner syndrome had this finding (P < .001). In all patients, both Horner syndrome and carotid wall hematoma had resolved 7 days ± 1 after SPAC.
CONCLUSION: Horner syndrome appears to be a common yet transient event after SPAC. Although postinterventional Horner syndrome is significantly related to ipsilateral carotid wall hematoma, causality of the procedure-related formation of a carotid wall hematoma and oculosympathetic disturbance remains unproven.