{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T00:05:57Z","timestamp":1764720357869,"version":"3.46.0"},"reference-count":12,"publisher":"Georg Thieme Verlag KG","issue":"04","license":[{"start":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T00:00:00Z","timestamp":1750809600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Asian J Neurosurg"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Horner's syndrome, characterized by ptosis, miosis, and anhidrosis, results from oculosympathetic complex injury, often due to trauma affecting the superior cervical ganglion. Although rare following carotid surgery, we present a case of Horner's syndrome after elective carotid endarterectomy (CEA). This report explores potential mechanism, including prolonged surgical retraction and hematoma formation, while reviewing similar cases in the literature. A 45-year-old woman presented with recurrent dizziness and progressive left-sided hearing impairment over 5 years. She also reported neck discomfort and experienced five episodes of amaurosis fugax in her left eye within 1 week. Computed tomography revealed occlusion of the right common and internal carotid artery (ICA), along with a 90% stenosis at the left common carotid bifurcation extending into the left ICA. Subsequently, an elective left CEA was performed. Within 24\u2009hours postoperatively, she developed clinical signs of Horner's syndrome, including left-sided ptosis, miosis, anhidrosis, and concurrent facial nerve palsy. Notably, there was no evidence of hematoma formation or sensorimotor deficits. This case highlights the rare occurrence of Horner's syndrome as a postoperative complication of CEA. Surgeons should be mindful of anatomical variations and potential intraoperative mechanisms contributing to this complication to enhance prevention strategies. Recognizing this risk is essential for optimizing postoperative care and patient counseling.<\/jats:p>","DOI":"10.1055\/s-0045-1809897","type":"journal-article","created":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T19:04:06Z","timestamp":1750878246000},"page":"823-826","source":"Crossref","is-referenced-by-count":0,"title":["Horner's Syndrome after Carotid Endarterectomy: A Case Report and Review of Literature"],"prefix":"10.1055","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7271-6302","authenticated-orcid":false,"given":"Nadeem Ahmed","family":"Siddiqui","sequence":"additional","affiliation":[{"name":"Section of Vascular Surgery, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7035-1047","authenticated-orcid":false,"given":"Fatima","family":"Suleman","sequence":"additional","affiliation":[{"name":"Section of Vascular Surgery, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4493-414X","authenticated-orcid":false,"given":"Shoaib","family":"Muhammad","sequence":"additional","affiliation":[{"name":"Section of Vascular Surgery, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8373-5384","authenticated-orcid":false,"given":"Fareed","family":"Shaikh","sequence":"additional","affiliation":[{"name":"Section of Vascular Surgery, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,6,25]]},"reference":[{"key":"ref1","first-page":"35","article-title":"Horner syndrome: clinical perspectives","volume":"7","author":"S Kanagalingam","year":"2015","journal-title":"Eye Brain"},{"issue":"04","key":"ref2","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1177\/153857440103500414","article-title":"Horner's syndrome after carotid endarterectomy\u2013a case report","volume":"35","author":"C Perry","year":"2001","journal-title":"Vasc Surg"},{"issue":"01","key":"ref3","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1097\/IOP.0b013e318191febf","article-title":"Neck procedures resulting in Horner syndrome","volume":"25","author":"A Y Allen","year":"2009","journal-title":"Ophthalmic Plast Reconstr Surg"},{"issue":"02","key":"ref4","doi-asserted-by":"crossref","first-page":"e228244","DOI":"10.1136\/bcr-2018-228244","article-title":"Transient iatrogenic Horner's syndrome following carotid endarterectomy","volume":"12","author":"H Hidayat","year":"2019","journal-title":"BMJ Case Rep"},{"issue":"04","key":"ref5","doi-asserted-by":"crossref","first-page":"985","DOI":"10.1016\/j.jvs.2016.04.029","article-title":"Cranial nerve injury is associated with dual antiplatelet therapy use and cervical hematoma after carotid endarterectomy","volume":"64","author":"E Chisci","year":"2016","journal-title":"J Vasc Surg"},{"issue":"04","key":"ref6","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1177\/0145561319838248","article-title":"Horner syndrome secondary to metastatic squamous cell carcinoma in the neck: a case series","volume":"98","author":"S Lele","year":"2019","journal-title":"Ear Nose Throat J"},{"issue":"03","key":"ref7","doi-asserted-by":"crossref","first-page":"445","DOI":"10.3171\/jns.2004.101.3.0445","article-title":"Risk of persistent cranial nerve injury after carotid endarterectomy","volume":"101","author":"E J Cunningham","year":"2004","journal-title":"J Neurosurg"},{"issue":"03","key":"ref8","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1097\/WNO.0000000000000844","article-title":"Causes of Horner syndrome: a study of 318 patients","volume":"40","author":"M A Sabbagh","year":"2020","journal-title":"J Neuroophthalmol"},{"issue":"06","key":"ref9","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1016\/S0090-3019(00)00289-5","article-title":"Horner's syndrome after carotid artery stenting: case report","volume":"54","author":"A J Ringer","year":"2000","journal-title":"Surg Neurol"},{"issue":"08","key":"ref10","first-page":"1508","article-title":"Horner syndrome related to ipsilateral carotid wall hematoma after stent placement for the treatment of carotid stenoses","volume":"24","author":"M Rosenkranz","year":"2003","journal-title":"AJNR Am J Neuroradiol"},{"issue":"03","key":"ref11","doi-asserted-by":"crossref","first-page":"e410","DOI":"10.1097\/WNO.0000000000001918","article-title":"A rare case of Horner syndrome after carotid artery stenting","volume":"44","author":"N Sasaki","year":"2024","journal-title":"J Neuroophthalmol"},{"issue":"01","key":"ref12","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1159\/000535475","article-title":"Internal carotid artery dissection presenting with transient or subclinical Horner syndrome","volume":"15","author":"T Buelens","year":"2024","journal-title":"Case Rep Ophthalmol"}],"container-title":["Asian Journal of Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/s-0045-1809897.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T00:01:24Z","timestamp":1764720084000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/s-0045-1809897"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,25]]},"references-count":12,"journal-issue":{"issue":"04","published-online":{"date-parts":[[2025,12,2]]},"published-print":{"date-parts":[[2025,12]]}},"URL":"https:\/\/doi.org\/10.1055\/s-0045-1809897","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["1793-5482","2248-9614"],"issn-type":[{"type":"print","value":"1793-5482"},{"type":"electronic","value":"2248-9614"}],"subject":[],"published":{"date-parts":[[2025,6,25]]}}}