What is the cause of this patient’s droopy eye?

This 55-year-old female presents with a droopy eye, which isn’t something to be taken lightly. In this particular case, the droopy eye is symptomatic of a syndrome with a name you might remember.

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Remember Horner’s syndrome, i.e. ptosis meiosis anhydrosis? Here is the classic cause, carotid dissection, with a meniscal curvilinear appearance of the vessel wall. If you hear this history, make a beeline for the carotid canal and you will have a great diagnosis. I have even seen neck vascular dissection from a sneeze.

For more neuro case review, check out MRI Online.

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