Horner-Syndrom bei Karotisdissektion nach chiropraktischer Manipulation

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.

Schlüsselwörter

Horner-Syndrom - Karotisdissektion - chiropraktische Manipulation

Key words

Horner's syndrome - dissection of the carotid artery - chiropractic manipulation

Literatur

• 1 Assaf M, Sweeney P J, Kosmorsky G, Masaryk T. Horner's syndrome secondary to angiogram negative, subadventitial carotid artery dissection.  Can J Neurol Sci. 1993;  20 (1) 62-64
• 2 Ast G, Woimant F, Georges B, Laurian C, Haguenau M. Spontaneous dissection of the internal carotid artery in 68 patients.  Eur J Med. 1993;  2 (8) 466-472
• 3 Biousse V, D'Anglejan-Chatillon J, Massiou H, Bousser M G. Head pain in non-traumatic carotid artery dissection: a series of 65 patients.  Cephalalgia. 1994;  14 (1) 33-36
• 4 Biousse V, Touboul P J, D'Anglejan-Chatillon J, Levy C, Schaison M, Bousser M G. Ophthalmologic manifestations of internal carotid artery dissection.  Am J Ophthalmol. 1998;  126 (4) 565-577
• 5 Biousse V, Schaison M, Touboul P J, D'Anglejan-Chatillon J, Bousser M G. Ischemic optic neuropathy associated with internal carotid artery dissection.  Arch-Neurol. 1998b;  55 (5) 715-719
• 6 Bousson V, Levy C, Brunereau L, Djouhri H, Tubiana J M. Dissections of the internal carotid artery: three-dimensional time-of-flight MR angiography and MR imaging features.  Am J Roentgenol. 1999;  173 (1) 139-143
• 7 Brown J, Danielson R, Donahue S P, Thompson H S. Horner's syndrome in subadventitial carotid artery dissection and the role of magnetic resonance angiography.  Am J Ophthalmol. 1995;  119 (6) 811-813
• 8 Ducrocq X, Lacour J C, Debouverie M, Bracard S, Girard F, Weber M. Ischemic cerebral vascular events in young subjects: a prospective study in 296 patients aged 16 to 45 years.  Revue Neurologique. 1999;  155 (8) 575-582
• 9 Fay T. Atypical facial neuralgia, a syndrome of vascular pain.  Ann Otol Rhinol Laryngol. 1932;  41 1030-1062
• 10 Fletcher J, Davies P T, Lewis T, Campbell M J. Traumatic carotid and vertebral artery dissection in a professional jockey: a cautionary tale.  Br J Sports Med. 1995;  29 (2) 143-144
• 11 Foster R E, Kosmorsky G S, Sweeney P J, Masaryk T J. Horner's syndrome secondary to spontaneous carotid dissection with normal angiographic findings.  Arch Ophthalmol. 1991;  109 1499-1500
• 12 Gittinger J W. Occipital infarction following chiropractic cervical manipulation.  J Clin Neuroophthalmol. 1986;  6 (1) 11-13
• 13 Grayson M F. Horner's syndrome after manipulation of the neck.  Br Med J (Clin Res Ed). 1987;  295 (6610) 1381-1382
• 14 Heine S, Wilhelm H, Zrenner E. Karotisdissektion mit Horner-Syndrom nach chiropraktischer Behandlung der Halswirbelsäule.  Z prakt Augenheilkd. 1998;  19 333-336
• 15 Hoffmeister A W, Neumann M, Fritz C. Spontane Dissektion der Arteria carotis interna.  Fortschr Med. 1992;  110 371-373
• 16 Kline L B, Vitek J J, Raymon B C. Painful Horner's syndrome due to spontaneous carotid artery dissection.  Ophthalmology. 1987;  94 226-230
• 17 Mokri B, Sundt T M, Houser O W, Piepgras D G. Spontaneous dissection of the cervical internal carotid artery.  Ann Neurol. 1986;  19 126-138
• 18 Mokri B, Schievink W I, Olsen K D, Piepgras D G. Spontaneous dissection of the cervical internal carotid artery.  Arch Otolaryngol Head Neck Surg. 1992;  118 431-435
• 19 Nagy A N, Hayman L A, Diaz-Marchan P J, Lee A G. Horner's syndrome due to first-order neuron lesions of the oculosympathetic pathway.  Am J Roentgenol. 1997;  169 (2) 581-584
• 20 Parenti G, Marconi F, Canapicchi R, Puglioli M, Giraldi C. Spontaneous recanalisation of carotid artery occlusion following non traumatic dissection.  Ital J Neurol Sci. 1989;  10 361-367
• 21 Parwar B L, Fawzi A A, Arnold A C, Schwartz S D. Horner's syndrome and dissection of the internal carotid artery after chiropractic manipulation of the neck.  Am J Ophthalmol. 2001;  131 (4) 523-524
• 22 Raskind R, North C M. Vertebral artery injuries following chiropractic cervical spin manipulation - case reports.  Angiology. 1990;  41 (6) 445-452
• 23 Schievink W I, Atkinson J L, Bartleson J D, Whisnant J P. Traumatic internal carotid artery dissections caused by blunt softball injuries.  Am J Emerg Med. 1998;  16 (2) 179-182
• 24 Taber K H, Ford J J, Hayman L A. Magnetic resonance imaging appearance of hemorrhage: sources of contrast. In: Hayman LA, Taber KH (eds) Neuroimaging Clinics of North America. Philadelphia; WB Saunders Co 1992 2: 61
• 25 van Gijn J, Koudstaal P J. Transient hypoglossal nerve palsy and Horner's syndrome: carotid dissection.  J Neurol Neurosurg Psychiatry. 1991;  54 (11) 1032
• 26 Vighetto A, Lisovoski F, Revol A, Trillet M, Aimard G. Internal carotid artery dissection and ipsilateral hypoglossal nerve palsy.  J Neurol Neurosurg Psychiatry. 1990;  53 (6) 530-531
• 27 Watridge C B, Muhlbauer M S, Lowery R D. Traumatic carotid artery dissection: diagnosis and treatment.  J Neurosurg. 1989;  71 (6) 854-857
• 28 West T E, Davies R J, Kelly R E. Horner's syndrome and headache due to carotid artery disease.  Br Med J. 1976;  1 (6013) 818-820
• 29 Wilhelm H, Wilhelm B, Kriegbaum C. Interaction of the indirectly acting topical sympathomimetics cocaine and pholedrine.  Ger J Ophthalmol. 1996;  5 (3) 168-170