In 1852 Claude Bernard first described his classical triad of mydriasis, widened palpebral fissure, and slight exophthalmos. Since the original account by Bernard, vasoconstriction, hypothermia, and hyperhidrosis have come to be considered within the same syndrome. Often these latter symptoms are absent, slight, or latent. Pupillary reactions to light and accomodation usually remain, but they may be decreased.
The syndrome is the result of a central or peripheral irritative lesion. Centrally, it can be located in the hypothalamus, midbrain, medulla, or cervical cord and result from neoplasm, encephalitis, or syphilis. Peripheral lesions include cervical rib, aneurysms of thoracic vessels, mediastinal tumors, tuberculous pleurisy, retropharyngeal tumors, swollen thyroid, enlargement of cervical lymph nodes, hematoma in the neck, and aortic dilatation.1 To our knowledge, a thrombosed common carotid artery has not been associated with lid retraction.
Shapiro reported on 17 cases of spontaneous thrombosis of the carotid arteries.2 Generalized findings
ELANDER CR, BEDROSSIAN RH, SCHAERER JP. Unilateral Lid RetractionAssociation with Common Carotid Thrombosis. AMA Arch Ophthalmol. 1957;57(1):37-38. doi:10.1001/archopht.1957.00930050043009