Sitara M Weerakoon1, Sonja E Stutzman2, Folefac D Atem3, Kelly S Kuchenbecker2, DaiWai M Olson2, Venkatesh Aiyagari4. 1. University of Texas Health Science Center School of Public Health, Department of Epidemiology, Human Genetics, and Environmental Sciences, Dallas, Texas. 2. University of Texas Southwestern Medical Center, Department of Neurological Surgery and Neurology and Neurotherapeutics, Dallas, Texas. 3. University of Texas Health Science Center School of Public Health, Department of Biostatistics and Data Science, Dallas, Texas. 4. University of Texas Southwestern Medical Center, Department of Neurological Surgery and Neurology and Neurotherapeutics, Dallas, Texas. Electronic address: Venkatesh.Aiyagari@utsouthwestern.edu.
Abstract
INTRODUCTION: Horner's syndrome has been reported after carotid artery endarterectomy (CEA) and carotid artery stenting (CS). This study evaluates pupillary changes after these procedures using automated pupillometry. METHODS: Retrospective analysis from a prospective database of pupillometry readings. Cases (14 patients with CEA/CS) were matched to controls (14 patients without CEA/CS). t test models were constructed to examine pupillary light reflex measures for CEA, CS, and controls. RESULTS: The 28 subjects had a mean age of 70 years, 50% were male, and 96% were Caucasian. There was no significant difference in the mean pupil size, constriction velocity (CV), dilation velocity (DV) between the procedural side compared to the contralateral side. However, the mean DV in the left eye after a left sided procedure among CS patients (.67) was lower than mean DV in left eye among controls (.88; P < .0001) and patients undergoing CEA (1.03; P < .0001). DISCUSSION: CS may result in disruption of the carotid artery plexus and decreased sympathetic response thereby reducing DV in the ipsilateral pupil. In addition, decreased CV can also been seen. CONCLUSION: The findings confirm and extend those of previous authors suggesting that pupillary changes may be seen after CS and automated handheld pupillometry may aid in the detection of Horner Syndrome.
INTRODUCTION:Horner's syndrome has been reported after carotid artery endarterectomy (CEA) and carotid artery stenting (CS). This study evaluates pupillary changes after these procedures using automated pupillometry. METHODS: Retrospective analysis from a prospective database of pupillometry readings. Cases (14 patients with CEA/CS) were matched to controls (14 patients without CEA/CS). t test models were constructed to examine pupillary light reflex measures for CEA, CS, and controls. RESULTS: The 28 subjects had a mean age of 70 years, 50% were male, and 96% were Caucasian. There was no significant difference in the mean pupil size, constriction velocity (CV), dilation velocity (DV) between the procedural side compared to the contralateral side. However, the mean DV in the left eye after a left sided procedure among CSpatients (.67) was lower than mean DV in left eye among controls (.88; P < .0001) and patients undergoing CEA (1.03; P < .0001). DISCUSSION: CS may result in disruption of the carotid artery plexus and decreased sympathetic response thereby reducing DV in the ipsilateral pupil. In addition, decreased CV can also been seen. CONCLUSION: The findings confirm and extend those of previous authors suggesting that pupillary changes may be seen after CS and automated handheld pupillometry may aid in the detection of Horner Syndrome.
Authors: Brenton R Prescott; Hanife Saglam; Jonathan A Duskin; Matthew I Miller; Arnav S Thakur; Eesha A Gholap; Meghan R Hutch; Stelios M Smirnakis; Sahar F Zafar; Josée Dupuis; Emelia J Benjamin; David M Greer; Charlene J Ong Journal: Crit Care Med Date: 2022-02-01 Impact factor: 9.296
Authors: Prachi Singh; Sonia E Stutzman; Aardhra Venkatachalam; DaiWai M Olson; Arianna Barnes; Folefac D Atem Journal: Rev Bras Ter Intensiva Date: 2021 Jul-Sep