Paratrigeminal Neuralgia that Improved with Treatment of Hypertension in a Patient with Raeder’s Syndrome After Carotid Artery Stenting

Abstract

BACKGROUND: Although there have been reports of Raeder’s syndrome developing after carotid artery dissection, to our knowledge, no case of Raeder’s syndrome occurring after carotid stenting has been reported. CASE REPORT: A 46-year-old man was urgently treated with a self-expanding stent for idiopathic right carotid artery dissection. However, the patient complained of moderate oppressive pain in the right orbit and forehead immediately after stent placement. Further examination revealed a right eye miosis and right ptosis. No anhidrosis was noted. A diagnosis of Raeder’s syndrome was made based on partial Horner’s syndrome and pain in the first branch of the trigeminal nerve. We noticed that he had hypertension and started antihypertensive medication. After starting the antihypertensive medication, his blood pressure stabilized, and his periorbital pain disappeared dramatically as his blood pressure fell. However, Horner’s symptoms (miosis and ipsilateral ptosis) were still present. CONCLUSION: We experienced a case of Raeder’s syndrome that occurred after stenting of the carotid artery. Neuralgia improved by treatment of hypertension. It should be noted that the paratrigeminal neuralgia of Raeder’s syndrome after carotid stenting can be caused by hypertension. KEY WORDS: Antihypertensive medication, Horner’s symptoms, Raeder’s syndrome, stenting of the carotid artery