Simultaneous and Sequential Development of Sixth Nerve Palsy and Horner’s Syndrome from Carotid Cavernous Sinus Fistulas
Bibliographic record
Abstract
The combination of ipsilateral sixth nerve palsy (6NP) and Horner's syndrome (Horner's) is a localizing sign of an injury to the posterior cavernous sinus. The presentation and clinical course of 3 patients presenting with coexisting ipsilateral 6NP and Horner's as a result of carotid cavernous sinus fistulas (CCFs) are discussed in this case series. We highlight these cases to show the possible sequence of events: (i) simultaneous discovery of 6NP and Horner's, (ii) 6NP followed by Horner's, and (iii) Horner's followed by 6NP. It is important to carefully assess for Horner's in patients with 6NP as this has high localizing value. In patients with a red eye consistent with a CCF, identifying Horner's also has high localizing value and can confirm the suspicion of a CCF. Clinicians should recognize that although 6NP and Horner's localize to the cavernous sinus and may be due to a CCF, they may appear in isolation or sequentially. It is also important to understand that Horner's and 6NP have different prognoses: 6NP usually resolves over time, whereas Horner's tends to persist.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".