A rare cause of Claude-Bernard-Horner syndrome

Key words: Ptosis, Miosis, Facial anhidrosis, Children, Arteriovenous malformation

Claude-Bernard-Horner syndrome is a disorder of the oculosympathetic pathway. At the onset, the classic triad of signs and symptoms consists in eyelid ptosis, ipsilateral miosis and facial anhidrosis. In children, the etiologies of this syndrome could be congenital causes, including birth trauma, carotid abnormalities and acquired ones, comprising surgery sequelae, neoplasm, and benign neck masses or infections. The paper presents the case of a five-year-old girl, transferred to our Emergency Department for sudden right eyelid ptosis and ipsilateral miosis; mild enophthalmos has been checked during the visit. The brain MRI exam showed a cervical spinal cord right-paramedian haemorrhagic lesion extending from C4 to D1, involving the right anterior medullary horn and part of the upper limb motor pathway, compatible with an arteriovenous malformation. This is the first case of Horner syndrome provoked by spontaneous spinal cord haemorrage based on a vascular malformation treated at the Paediatric hospital in Turin, Italy.