Harlequin syndrome after extrapleural bupivacaine infusion

Pain control after thoracotomy. An extrapleural tunnel to provide a continuous bupivacaine infusion for intercostal nerve blockade.

This study was undertaken to determine whether an infusion of local anesthetic (LA) delivered through an extrapleural tunnel could provide satisfactory control of pain in the postthoracotomy period. Twelve patients undergoing thoracotomy were studied. A T-shaped tunnel was created by elevating the parietal pleura at the posteromedial end of the thoracotomy wound. An irrigation catheter was then...

Harlequin Syndrome

Haemorrhage after extrapleural pneumonolysis.

Moderate or massive haemorrhage into the extrapleural space within a few days of the performance of an extrapleural pneumonolysis occurs in from 5 per cent to 20 per cent of cases. It may give rise to few symptoms, or be severe enough to cause alarming collapse of the patient and justify, if not demand, immediate transfusion. Apart from the immediate and more alarming physiological disturbances...

Compartment syndrome after pressurized infusion.

Compartment syndrome is caused by any condition which increases interstitial pressure within a muscle compartment to the extent that blood flow is compromised. It is seen classically after trauma to an extremity with crush injury, vascular damage or subsequent tight bandaging. Its sequelae may include irreversible neural and muscular damage secondary to the ischaemic insult. Previously describe...

Harlequin Syndrome in Cluster Headache.

A 63-year-old male experienced 3 years of excruciating, right retro-orbital, 15–90 minute headaches occurring 1 to 3 times daily associated with ipsilateral lacrimation, ptosis, and facial congestion. The episodes began after a complicated right root canal procedure. He also reported separate episodes of distinct left sided facial flushing triggered by exertion as evidenced by a photo that he p...