Presentation
Two weeks of right sided headache. Right side (partial) ptosis.
Patient Data
Right ICA dissection. Note elongated right styloid process in contact wih ICA.
Cervical sympathetic chain anatomy. Compression of post ganglionic sympathetic nerve fibers can cause a partial ptosis (if with miosis and anhydrosis = Horners Syndrome).
Image from American Academy of Opthamology, 2020, Horner Syndromw, viewed 16 April 2020,https://www.aao.org/oculoplastics-center/horner-syndrome-8
Treatment was conservative/medical.
Subsequent MRI head and neck - NAD. Resolution of dissection. No intracranial infarction. Ptosis resolved.
Case Discussion
Rare but recognized complication of a congenitally long styloid process.
Useful to think about the anatomy underlying the patients partial ptosis.