A 75‐year‐old man presented with right hemiparesis secondary to a left thalamic haemorrhage. Five days after presentation, he developed left Horner syndrome. He had left ptosis (Figure, A) with palpebral aperture measured at 3 mm on the left (7 mm on the right). In a well lit room, the left pupil measured 2 mm, while in a dark room, it was 3 mm, confirming miosis. Relative afferent pupillary defect was absent. Left‐sided anhidrosis was also present. A magnetic resonance imaging scan revealed extension of the haemorrhage into the thalamo‐mesencephalic junction (Figure, B–D).
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