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Título

Raeder syndrome: case report

RESUMO

CASE PRESENTATION: A 33-year-old male patient, without any previous disease, was admitted due to a headache in the left frontal region of the head, pulsating, with strong intensity that started 03 days ago. He denied and previous similar episodes. On admission examination, he had left palpebral semiptosis associated with ipsilateral myosis, with no other clinical signs. During clinical investigation, a brain magnetic resonance was performed, which showed no alterations. However, the brain angiotomography elucidated an important tapering of the left internal carotid artery. Later, an angiography was performed that confirmed carotid artery dissection on the left of the cervical portion with severe stenosis in the segment, which led the patient to undergo to angioplasty. Patient evolved with improvement of pain and normalization of the neurological examination

DISCUSSION: Paratrigeminal oculosympathetic syndrome or Raeder's Syndrome is a rare condition, with an incidence of 1 in 60,000, and was first described in 1924, consisting of a constant unilateral headache, accompanied by Horner's syndrome. Our patient fulfilled all the criteria according to the ICHD-3 classification. This syndrome can have several causes, such as tumor, infection, and trauma, but carotid dissection is the most common cause. It is divided into two groups, group I, which includes patients with additional involvement of some parasellar nerve (III, IV or VI) and group II, where the parasellar nerves are not affected. This second group usually has a good and self-limiting evolution.

FINAL COMMENTS: We present a rare cause of secondary headache that, after its correct etiological investigation, had a favorable clinical outcome for the patient.

Palavras Chave

Raeder's Syndrome; headache; Paratrigeminal oculosympathetic syndrome