Horner's Syndrome: Clinical and Radiographic Evaluation

      Horner's syndrome (HS) occurs when there is interruption of the oculosympathetic pathway (OSP). This article reviews the anatomy of the OSP and clinical findings associated with lesions located at various positions along this pathway. The imaging findings of lesions associated with HS at various levels of the OSP, classified as preganglionic HS (first- and second-order neuron HS) or postganglionic HS (third-order neuron HS), are demonstrated.

      Keywords

      To read this article in full you will need to make a payment
      Purchase one-time access
      Subscribers receive full online access to your subscription and archive of back issues up to and including 2002.
      Content published before 2002 is available via pay-per-view purchase only.
      Subscribe to Neuroimaging Clinics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Amonoo-Kuofi H.S.
        Horner's syndrome revisited: with an update of the central pathway.
        Clin Anat. 1999; 12: 345-361
        • Thompson H.S.
        The pupil.
        in: Hart Jr., W.M. Adler's physiology of the eye. 9th edition. Mosby-Year Book, St. Louis (MO)1992: 412-441
        • Burde R.M.
        • Savino P.J.
        • Trobe J.D.
        Anisocoria and abnormal papillary light reactions.
        in: Kist K.M. Clinical decisions in neuro-ophthalmology. 2nd edition. Mosby-Year Book, St. Louis (MO)1992: 321-346
        • Snell R.S.
        • Lemp M.A.
        The autonomic nervous system.
        in: Clinical anatomy of the eye. Blackwell Scientific Publications, Boston1989: 297-317
        • Horner J.F.
        On a form of ptosis.
        Klin Monatsbl Augenheilkd. 1869; 7: 193-198
        • Lepore F.E.
        Enophthalmos and Horner's syndrome.
        Arch Neurol. 1983; 40: 460
        • Smith G.
        • Dyches T.J.
        • Burden R.M.
        Topographic analysis of Horner's syndrome.
        Otolaryngol Head Neck Surg. 1986; 94: 451-457
        • Weinstein J.M.
        • Lweifel T.J.
        • Thompson H.S.
        Congenital Horner's syndrome.
        Arch Ophthalmol. 1980; 98: 1074-1078
        • Morrison D.A.
        • Bibby K.
        • Woodruff G.
        The “harlequin” sign and congenital Horner's syndrome.
        J Neurol Neurosurg Psychiatry. 1997; 62: 626-628
        • Wilhelm H.
        • Welhelm B.
        • Kriegbaum C.
        Interaction of the indirectly acting topical sympathomimetics cocaine and pholegrine.
        Ger J Ophthalmol. 1996; 5: 168-170
        • Nagy A.N.
        • Hayman L.A.
        • Diaz-Marchan P.J.
        • et al.
        Horner's syndrome due to first-order neuron lesions of the oculosympathetic pathway.
        AJR Am J Roentgenol. 1997; 169: 581-584
        • Digre K.B.
        • Smoker W.R.K.
        • Johnston P.
        • et al.
        Selective MR imaging approach for evaluation of patients with Horner's syndrome.
        AJNR Am J Neuroradiol. 1992; 13: 223-227
        • Sacco R.L.
        • Freddo L.
        • Bello J.A.
        • et al.
        Wallenberg's lateral medullary syndrome: clinical-magnetic resonance imaging correlations.
        Arch Neurol. 1993; 50: 609-614
        • Pomeranz H.
        Isolated Horner syndrome and syrinx of the cervical spinal cord.
        Am J Ophthalmol. 2002; 133: 702-704
        • Ellis C.J.K.
        Editorial commentary: isolated Horner's syndrome and syringomyelia.
        J Neurol Neurosurg Psychiatry. 2000; 69: 3-4
        • Kerrison J.B.
        • Biousse V.
        • Newman N.J.
        Isolated Horner's syndrome and syringomyelia.
        J Neurol Neurosurg Psychiatry. 2000; 69: 131-132
        • Ottomo M.
        • Heimburger R.F.
        Alternating Horner syndrome and hyperhidrosis due to dural adhesions following cervical spinal cord injury.
        J Neurosurg. 1980; 53: 97-100
        • Shen C.C.
        • Wang Y.C.
        • Yang D.Y.
        • et al.
        Brown-Sequard syndrome associated with Horner's syndrome in cervical epidural hematoma.
        Spine. 1995; 20: 244-247
        • Detterbeck F.C.
        Pancoast (superior sulcus) tumors.
        Ann Thorac Surg. 1997; 63: 1810-1818
        • Attar S.
        • Krasna M.J.
        • Sonett J.R.
        • et al.
        Superior sulcus (pancoast) tumor: experience with 105 patients.
        Ann Thorac Surg. 1998; 66: 193-198
        • Rosner M.
        • Fisher W.
        • Mulligan L.
        Cervical sympathetic schwannoma: case report.
        Neurosurgery. 2001; 49: 1452-1454
        • Hood R.J.
        • Jensen M.E.
        • Reibel J.F.
        • et al.
        Schwannoma of the cervical sympathetic chain.
        Ann Otol Rhinol Laryngol. 2000; 109: 48-51
        • Clements D.M.
        • Hedges A.R.
        • Tudor G.R.
        Horner's syndrome following excision of a vagal paraganglionoma.
        Int J Clin Pract. 2002; 56: 626-627
        • Lopez I.B.
        • Schwartz A.
        Neuroblastoma.
        Pediatr Clin North Am. 1985; 32: 755-778
        • Shimada H.
        • Ambros I.
        • Dehner L.
        • et al.
        Terminology and morphologic criteria of neuroblastic tumors.
        Cancer. 1999; 86: 349-363
        • Aljassim A.H.H.
        Cervical ganglioneuroblastoma.
        J Laryngol Otol. 1987; 101: 296-301
        • Moukheiber A.K.
        • Nicollas R.
        • Roman S.
        • et al.
        Primary pediatric neuroblastic tumors of the neck.
        Int J Pediatr Otorhinolaryngol. 2001; 60: 155-161
        • Levin R.
        • Newman S.A.
        • Login I.S.
        Bilateral Horner's syndrome secondary to multinodular goiter.
        Ann Intern Med. 1986; 105: 550-551
        • Cengiz K.
        • Aykin A.
        • Demirci A.
        • et al.
        Intrathoracic goiter with hyperthyroidism, tracheal compression, superior vena cava syndrome and Horner's syndrome.
        Chest. 1990; 97: 1005-1006
        • Kumar R.
        • Buckley T.F.
        First disc protrusion.
        Spine. 1986; 11: 499-501
        • Inci S.
        • Bertan V.
        • Kansu T.
        • et al.
        Horner's syndrome due to jugular venous ectasia.
        Childs Nerv Syst. 1995; 11: 533-535
        • Delabrousse E.
        • Kastler B.
        • Bernard Y.
        • et al.
        MR diagnosis of a congenital abnormality of the thoracic aorta with an aneurysm of the right subclavian artery presenting as a Horner's syndrome in an adult.
        Eur Radiol. 2000; 10: 650-652
        • Ekatodramis G.
        • Macaire P.
        • Borgeat A.
        Prolonged Horner syndrome due to neck hematoma after continuous interscalene block.
        Anesthesiology. 2001; 95: 801-803
        • Bell R.L.
        • Atweh N.
        • Ivy M.E.
        • et al.
        Traumatic and iatrogenic Horner syndrome: case reports and review of the literature.
        J Trauma. 2001; 51: 400-404
        • Auer D.
        • Karnath H.O.
        • Nagele T.
        • et al.
        Case report: noninvasive investigation of pericarotid syndrome: role of MR angiography in the diagnosis of internal carotid dissection.
        Headache. 1995; 35: 163-168
        • Guy N.
        • Deffond D.
        • Gabrillargues J.
        • et al.
        Spontaneous internal carotid artery dissection with lower cranial nerve palsy.
        Can J Neurol Sci. 2001; 28: 265-269
        • Chan C.C.
        • Paine M.
        • O'Day J.
        Carotid dissection: a common cause of Horner's syndrome.
        Clin Experiment Ophthalmol. 2001; 29: 411-415
        • Leira E.C.
        • Bendixen B.H.
        • Kardon R.H.
        • et al.
        Brief, transient Horner's syndrome can be the hallmark of a carotid artery dissection.
        Neurology. 1998; 50: 289-290
        • Brown J.
        • Danielson R.
        • Donahue S.P.
        • et al.
        Horner's syndrome in subadventitial carotid artery dissection and the role of magnetic resonance angiography.
        Am J Ophthalmol. 1995; 119: 811-813
        • Khurana R.K.
        Bilateral Horner's syndrome in cluster type headaches.
        Headache. 1993; 33: 449-451
        • Coley S.C.
        • Clifton A.
        • Britton J.
        Giant aneurysm of the petrous internal carotid artery: diagnosis and treatment.
        J Laryngol Otol. 1998; 112: 196-198
        • Zander D.R.
        • Just N.
        • Schipper H.M.
        Aneurysm of the intrapetrous internal carotid artery presenting as isolated Horner's syndrome: case report.
        Can Assoc Radiol J. 1998; 49: 46-48
        • Ryan F.H.
        • Kline L.B.
        • Gomez C.
        Congenital Horner's syndrome resulting from agenesis of the internal carotid artery.
        Ophthalmology. 2000; 107: 185-188
        • Dinc H.
        • Alioglu Z.
        • Erdöl H.
        • et al.
        Agenesis of the internal carotid artery associated with aortic anomaly in a patient with congenital Horner's syndrome.
        AJNR Am J Neuroradiol. 2002; 23: 929-931