"Pneumo-ptosis" in the emergency department

Am J Emerg Med. 1992 Sep;10(5):431-4. doi: 10.1016/0735-6757(92)90070-e.


The authors report the case of a 16-year-old female who presented with a left tension pneumothorax and a left Horner's syndrome. Chest tube thoracostomy performed to relieve the tension pneumothorax also resulted in the immediate resolution of the patient's ptosis and miosis. The probable mechanism for the patient's focal neurologic signs was traction upon the cervical sympathetic chain secondary to the mediastinal shift of the tension pneumothorax. This case demonstrates that unequal pupils in the presence of a pneumothorax could represent Horner's syndrome.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Algorithms
  • Bronchi / abnormalities
  • Bronchi / surgery
  • Chest Tubes
  • Eye / innervation
  • Female
  • Horner Syndrome / etiology*
  • Horner Syndrome / physiopathology
  • Humans
  • Pneumonectomy / methods
  • Pneumothorax / complications*
  • Pneumothorax / diagnostic imaging
  • Pneumothorax / therapy
  • Radiography
  • Sympathetic Nervous System / anatomy & histology