Materiały źródłowe

• #1 Horner Syndrome: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17836-horners-syndrome

  Horner syndrome is a rare neurological syndrome that affects your eye and the surrounding area on one side of your face. Its a sign of underlying nerve damage and has several possible causes ranging from carotid artery dissection to apical lung tumor. […] Most often, Horner syndrome happens as a result of blockage or damage to the sympathetic nerves that lead to your eyes. The underlying causes of nerve damage can vary widely, from a middle ear infection to a carotid artery dissection or apical chest tumor. […] In rare cases, Horner syndrome is a congenital condition, meaning its present at birth. Usually, the congenital form occurs because of some type of birth trauma or injury to the nerves or carotid artery during delivery. […] Three different nerve pathways may be involved in Horner syndrome. The nerves from your brain dont travel along a direct path to your eyes and face. They travel along three paths, and disruption can occur in any of these pathways. Because of this, there are three types of Horner syndrome with different possible causes.

• #2 Horner Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK500000/

  Horner syndrome is primarily an acquired condition secondary to systemic/local diseases or iatrogenic causes but may be congenital and purely hereditary in some rare cases. […] Sympathetic fibers have an extensive course and can be interrupted during extracranial, intracranial, or intra-orbital traversal. […] The sympathetic fibers may be interrupted centrally, between the hypothalamus and the exit point of fibers from the spinal cord (C8 to T2), or the discontinuation could be peripheral, in the cervical sympathetic chain, at the level of superior cervical ganglion, or along the course of the carotid artery. […] Preganglionic Horner syndrome can be an ominous sign due to its association with pulmonary malignancies. […] Overall, the causes of Horner syndrome can be divided according to the anatomical location of disruption.

• #3 Horner Syndrome: Overview, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/1220091-overview

  Horner syndrome can be congenital, acquired, or purely hereditary (autosomal dominant). The interruption of the sympathetic fibers may occur centrally (ie, between the hypothalamus and the fibers point of exit from the spinal cord [C8 to T2]) or peripherally (ie, in cervical sympathetic chain, at the superior cervical ganglion, or along the carotid artery). […] The common lesions that cause Horner syndrome interfere with preganglionic fibers as they course through the upper thorax. Virtually all lesions producing postganglionic sympathetic dysfunction are located intracranially or intraorbitally because the superior cervical ganglion is near the skull. Preganglionic Horner syndrome indicates a serious underlying pathology and is associated with a high incidence of malignancy. Postganglionic involvement has primarily benign causes (ie, usually a vascular headache).

• #4 Horner Syndrome: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17836-horners-syndrome

  Horner syndrome is a rare neurological syndrome that affects your eye and the surrounding area on one side of your face. Its a sign of underlying nerve damage and has several possible causes ranging from carotid artery dissection to apical lung tumor. […] Most often, Horner syndrome happens as a result of blockage or damage to the sympathetic nerves that lead to your eyes. The underlying causes of nerve damage can vary widely, from a middle ear infection to a carotid artery dissection or apical chest tumor. […] In rare cases, Horner syndrome is a congenital condition, meaning its present at birth. Usually, the congenital form occurs because of some type of birth trauma or injury to the nerves or carotid artery during delivery. […] Three different nerve pathways may be involved in Horner syndrome. The nerves from your brain dont travel along a direct path to your eyes and face. They travel along three paths, and disruption can occur in any of these pathways. Because of this, there are three types of Horner syndrome with different possible causes.

• #5 Horner syndrome | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/horner-syndrome?lang=us

  Horner syndrome can be anatomically classified into three types, depending on where the pathology affects the sympathetic pathway. […] There is an extremely long list of causes. The main ones include: […] Central causes: hypothalamic, thalamic or brainstem ischemia (e.g. lateral medullary syndrome), hemorrhage, tumor, demyelination. […] Pre-ganglionic causes: apical lung mass/tumor (Pancoast tumor), cervical rib, cervicothoracic spine trauma, brachial plexus injury, thyroid mass/goiter/tumor, mediastinal mass tumor, common carotid artery pathology, injury to superior cervical ganglion. […] Post-ganglionic causes: internal carotid artery pathology, dissection, aneurysm, carotid-cavernous fistula, cavernous sinus thrombophlebitis, cavernous sinus mass, nasopharyngeal tumor.

• #6 Horner Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK500000/

  First-order neurons are mostly affected by intracranial conditions and include the following: Cerebral vascular accidents (CVA), Multiple sclerosis, Arnold-Chiari malformation, Encephalitis, Meningitis, Lateral medullary syndrome, Syringomyelia, Intracranial tumors (pituitary or basal skull), Spinal trauma above the T2-T3 level, Spinal cord tumors. […] Second-order neurons traverse the thoracic region and are affected by the following: Malignancies involving the apex of the lungs (Pancoast tumor), Cervical rib (tractional injury), Lesions of the subclavian artery (an aneurysm), Mediastinal lymphadenopathy, Trauma to brachial plexus, Neuroblastoma of the paravertebral sympathetic chain, A dental abscess involving the mandibular region, Iatrogenic (including thyroidectomy, radical neck dissection, tonsillectomy, coronary artery bypass grafting, or carotid angiography).

• #7 Horner Syndrome: Overview, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/1220091-overview

  Causes of Horner syndrome may also be classified as involving first-order, second-order, or third-order neuron lesions. First-order neuron lesions that may give rise to the syndrome include the following: Arnold-Chiari malformation, Basal meningitis (eg, syphilis), Basal skull tumors, Cerebral vascular accident (CVA)/Wallenberg syndrome (lateral medullary syndrome), Demyelinating disease (eg, multiple sclerosis), Lesions in the hypothalamus or medulla, Intrapontine hemorrhage, Neck trauma (eg, traumatic dislocation of cervical vertebrae or traumatic dissection of the vertebral artery) – Horner syndrome occurring in association with spinal cord trauma suggests a high cervical cord lesion because it does not occur with lesions below T2 or T3, Pituitary tumor, Syringomyelia. […] Second-order neuron lesions that may give rise to Horner syndrome include the following: Pancoast tumor (tumor in the apex of the lung, most commonly squamous cell carcinoma), Birth trauma with injury to lower brachial plexus, Cervical rib, Aneurysm or dissection of the aorta, Lesions of the subclavian or common carotid artery, Central venous catheterization, Trauma or surgical injury (eg, due to radical neck dissection, thyroidectomy, carotid angiography, radiofrequency tonsil ablation, chiropractic manipulation, or coronary artery bypass grafting), Chest tubes, Lymphadenopathy (eg, Hodgkin disease, leukemia, tuberculosis, or mediastinal tumors), Mandibular tooth abscess, Lesions of the middle ear (eg, acute otitis media), Neuroblastoma.

• #8 Horner Syndrome – EyeWiki

  https://eyewiki.org/Horner_Syndrome

  Horner’s syndrome (also called oculosympathetic paresis, or Horner syndrome) comprises a constellation of clinical signs including the classic triad of ptosis, miosis, and anhidrosis. It results from a lesion to the sympathetic pathway that supplies the head and neck region. The cause of Horner’s syndrome varies with the site of the lesion. Prompt evaluation is necessary to detect and treat potentially life-threatening conditions. […] The etiology of Horner’s syndrome varies with the patient age and site of lesion. The etiology remains unknown in 35-40% of cases. […] Central (first order neuron) Horner’s: These include lesions of the hypothalamus, brainstem and spinal cord such as stroke (classically the lateral medullary syndrome), demyelination (such as multiple sclerosis), neoplasms (such as glioma), or other processes such as a syrinx (syringomyelia or syringobulbia).

• #9 Horner’s Syndrome | Deranged Physiology

  https://derangedphysiology.com/main/required-reading/neurological-intensive-care/Chapter-4693/horners-syndrome

  Horner’s syndrome is a favoured topic of the college examiners, appearing in several: past paper SAQs: […] Some of these questions ask details about the possible position of the lesion. It is important to be intimately familiar with this syndrome, and with its differentials. […] Causes of Horners Syndrome, arranged in order of anatomical location: Hemispheric lesion (hemispherectomy, massive hemispheric CVA, thalamic CVA) […] Brainstem lesion (brainstem infarct, multiple sclerosis, brainstem tumour or encephalitis) […] Central cord lesion (syringomyelia, glioma, ependymoma, traumatic) […] T1 root lesion (Pancoast tumour, cervical rib, brachial plexus avulsion, aortic or subclavian aneurysm) […] Sympathetic chain (laryngeal, pharyngeal, thyroid or parathyroid surgery, carotid artery lesion, malignancy at base of skull).

• #10 Horner’s Syndrome: Symptoms, Causes, and Treatment | Doctor

  https://patient.info/doctor/horners-syndrome

  Horner’s syndrome causes (Aetiology)78 […] Central (first-order) nerve lesions […] Preganglionic (second-order) nerve lesions […] Postganglionic (third-order) nerve lesions […] Cerebrovascular accidents. […] Apical lung tumours (eg, Pancoast’s tumour). […] Cluster headaches or migraine. […] Multiple sclerosis. […] Lymphadenopathy (lymphoma, leukaemia, tuberculosis, mediastinal tumours). […] Herpes zoster infection. […] Pituitary or basal skull tumours. […] Lower brachial plexus trauma or cervical rib. […] Internal carotid artery dissection, may be traumatic.910 […] Basal meningitis (eg, syphilis). […] Aneurysms of the aorta, subclavian or common carotid arteries. […] Raeder’s syndrome (paratrigeminal syndrome). […] Neck trauma (eg, cervical vertebral dislocation or dissection of the vertebral artery).

• #11 Horner’s Syndrome – Emianopsia

  https://www.emianopsia.com/en/horner-syndrome/

  Bernard Horner syndrome also referred to as oculosympathetic paralysis, is the action of the parasympathetic system (rest and digestion) overriding the malfunctioning sympathetic system (attack and escape), the victim of an interruption in nerve signaling of the cervical sympathetic pathways from the hypothalamus to the eye. […] There are many causes, and it is necessary to identify them to establish treatment. […] Bernards syndrome can also have an idiopathic origin, i.e. without obvious reasons. […] Lesions are generally subdivided into: central (first neuron of the sympathetic pathway): skull base tumors (traumatic dislocation of cervical vertebrae or traumatic vertebral artery dissection), neck trauma, syringomyelia, multiple sclerosis and demyelinating diseases, encephalitis, lateral medullary syndrome (or Wallenberg syndrome), Chiari malformation, basal m (e.g. syphilis), lesions of the hypothalamus or medulla oblongata, intrapontine hemorrhage, pituitary tumor.

• #12 Horner’s Syndrome: Symptoms, Causes, Treatment, and More

  https://resources.healthgrades.com/right-care/brain-and-nerves/horners-syndrome

  Horner’s syndrome is often the result of an interruption to this group of nerves through physical injury. However, there is a rarer, congenital form present from birth. […] Horner’s syndrome is generally congenital or acquired through nerve injury. […] Damage to the sympathetic trunk can cause Horner’s syndrome. […] Conditions that can cause damage to first-order neurons include: multiple sclerosis, cerebral vascular accidents, Arnold-Chiari malformation, encephalitis, meningitis, lateral medullary syndrome, intracranial tumors, trauma to the spine above the T2-T3 vertebrae, syringomyelia, tumors on the spinal cord. […] When damage occurs to these neurons, it is likely due to: lung cancer, injury to the cervical rib, aneurysm, lymph node swelling in the chest, injury to your brachial plexus, neuroblastoma, dental abscess, reaction following surgery or a procedure.

• #13 Horner syndrome

  https://johnsonmemorial.org/jmh-health/disease-conditions/con-20373536

  Horner syndrome is caused by the disruption of a nerve pathway from the brain to the head and neck. […] Horner syndrome may be the result of another medical problem, such as a stroke, tumor or spinal cord injury. […] Horner syndrome is caused by damage to a certain pathway in the sympathetic nervous system. […] Problems in this region that can disrupt nerve function related to Horner syndrome include: Stroke, Tumor, Diseases that cause the loss of the protective sheath on neurons (myelin), Neck trauma, Cyst in the spinal column (syringomyelia). […] Causes related to nerve damage in this region may include: Lung cancer, Tumor of the myelin sheath (schwannoma), Damage to the main blood vessel leading from the heart (aorta), Surgery in the chest cavity, Traumatic injury. […] Nerve damage in this region may be associated with the following: Damage to the carotid artery along the side of the neck, Damage to the jugular vein along the side of the neck, Tumor or infection near the base of the skull, Migraines, Cluster headaches, a disorder that results in cyclical patterns of severe headaches.

• #14 Horner Syndrome | Concise Medical Knowledge

  https://www.lecturio.com/concepts/horner-syndrome/

  Most cases of Horner syndrome are idiopathic. Of the identified causes, the etiology depends on the location of the lesion. The causes vary between adult and pediatric populations. […] 1st-order syndrome (central) can be caused by stroke, tumor, or demyelination in the hypothalamus or brainstem. […] 2nd-order syndrome (preganglionic) can be caused by apical lung tumors, subclavian artery lesions, or cervical rib. […] 3rd-order syndrome (postganglionic) can be caused by internal carotid artery dissection, trauma, or herpes zoster. […] The etiology of Horner syndrome in children can include congenital factors such as trauma during birth or neuroblastoma, as well as acquired factors like brainstem tumors or neck trauma.

• #15 Horner syndrome | MedLink Neurology

  https://www.medlink.com/articles/horner-syndrome

  Horner syndrome is caused by an interruption of the oculosympathetic pathway that extends from the hypothalamus through the brainstem, upper spinal cord, paraspinal region, chest, neck, skull base, and orbit. […] Common causes of Horner syndrome are neck, chest, and upper spinal procedures, trauma, and tumors, as well as carotid dissection and cluster headache. […] The cause of Horner syndrome depends on whether the first-order, second-order, or third-order neuron is affected. […] First-order (central) Horner syndrome rarely occurs in isolation. […] Second-order (preganglionic) Horner syndrome often results from trauma or surgery to the paraspinal region, chest, and especially inferior jugular vein cannulation. […] Third-order (postganglionic) Horner syndrome is the most common and often only sign of carotid dissection, occurring in 38.5% to 44% of patients.

• #16 Horner’s Syndrome: Symptoms, Causes, and Treatment | Doctor

  https://patient.info/doctor/horners-syndrome

  Trauma or surgical injury (neck or chest).11 […] Carotid-cavernous fistula. […] Syringomyelia. […] Neuroblastoma. […] Temporal arteritis12 […] Arnold-Chiari malformation. […] Mandibular dental abscess. […] Spinal cord tumours. […] Horner’s syndrome associated with pain always needs investigation. If there is arm, shoulder or hand pain think of Pancoast’s syndrome. If pain is in the face or neck, think of carotid dissection. Pain and transient visual loss may be due to carotid dissection3 . […] In children, unless there is a known aetiology such as birth trauma, acquired Horner’s syndrome requires thorough investigation; there is frequently a serious underlying cause, including neuroblastoma, trauma, rhabdomyosarcoma and brainstem vascular malformation13 . […] A rare congenital form of Horner’s syndrome is described6 . It may present as an autosomal dominant condition or as a spontaneous mutation. […] Preganglionic lesions are less common but are more likely to be malignant.

• #17 Horner Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK500000/

  First-order neurons are mostly affected by intracranial conditions and include the following: Cerebral vascular accidents (CVA), Multiple sclerosis, Arnold-Chiari malformation, Encephalitis, Meningitis, Lateral medullary syndrome, Syringomyelia, Intracranial tumors (pituitary or basal skull), Spinal trauma above the T2-T3 level, Spinal cord tumors. […] Second-order neurons traverse the thoracic region and are affected by the following: Malignancies involving the apex of the lungs (Pancoast tumor), Cervical rib (tractional injury), Lesions of the subclavian artery (an aneurysm), Mediastinal lymphadenopathy, Trauma to brachial plexus, Neuroblastoma of the paravertebral sympathetic chain, A dental abscess involving the mandibular region, Iatrogenic (including thyroidectomy, radical neck dissection, tonsillectomy, coronary artery bypass grafting, or carotid angiography).

• #18 Horner Syndrome: Overview, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/1220091-overview

  Causes of Horner syndrome may also be classified as involving first-order, second-order, or third-order neuron lesions. First-order neuron lesions that may give rise to the syndrome include the following: Arnold-Chiari malformation, Basal meningitis (eg, syphilis), Basal skull tumors, Cerebral vascular accident (CVA)/Wallenberg syndrome (lateral medullary syndrome), Demyelinating disease (eg, multiple sclerosis), Lesions in the hypothalamus or medulla, Intrapontine hemorrhage, Neck trauma (eg, traumatic dislocation of cervical vertebrae or traumatic dissection of the vertebral artery) – Horner syndrome occurring in association with spinal cord trauma suggests a high cervical cord lesion because it does not occur with lesions below T2 or T3, Pituitary tumor, Syringomyelia. […] Second-order neuron lesions that may give rise to Horner syndrome include the following: Pancoast tumor (tumor in the apex of the lung, most commonly squamous cell carcinoma), Birth trauma with injury to lower brachial plexus, Cervical rib, Aneurysm or dissection of the aorta, Lesions of the subclavian or common carotid artery, Central venous catheterization, Trauma or surgical injury (eg, due to radical neck dissection, thyroidectomy, carotid angiography, radiofrequency tonsil ablation, chiropractic manipulation, or coronary artery bypass grafting), Chest tubes, Lymphadenopathy (eg, Hodgkin disease, leukemia, tuberculosis, or mediastinal tumors), Mandibular tooth abscess, Lesions of the middle ear (eg, acute otitis media), Neuroblastoma.

• #19 Horner Syndrome – EyeWiki

  https://eyewiki.org/Horner_Syndrome

  Preganglionic (second order neuron) Horner’s: These include lesions of the thoracic outlet (cervical rib, subclavian artery aneurysm), mediastinum (mediastinal tumors), pulmonary apex (Pancoast’s tumor), neck (thyroid malignancies) or the thoracic spinal cord (trauma) or surgical procedures in this region including radical neck dissection, jugular vein cannulation, thoracoscopy or mediastinoscopy, chest tube placement and other thoracic surgical procedures. […] Third order neuron or postganglionic lesion: These include lesions of the superior cervical ganglion (trauma, radical neck dissection or jugular vein ectasia), lesions of the internal carotid artery (ICA) in the neck and skull base (dissection, thrombosis, invasion by tumors or iatrogenic from endarterectomy or stenting, base of skull malignancies), lesions of ICA in the cavernous sinus (thrombosis, aneurysm, inflammation or invasive tumors) and lesions of the sellar and parasellar regions (invasive pituitary tumors, metastatic tumors, paratrigeminal tumors). Other causes include cluster headaches. […] In children, trauma (birth trauma or neck trauma) is the most common cause of Horner’s syndrome. […] Other causes include surgical trauma, neuroblastoma, brainstem lesions (such as vascular malformations, glioma and demyelination) and carotid artery thrombosis.

• #20 Pulsenotes | Horner’s syndrome

  https://app.pulsenotes.com/medicine/neurology/notes/horner-s-syndrome

  Horners syndrome is due to a lesion anywhere along the sympathetic pathway, also known as the oculosympathetic pathway. […] Horners syndrome develops due to a lesion anywhere along the oculosympathetic pathway. […] The aetiology of Horners syndrome can be divided by the order of neuron affected. […] Caused by a lesion anywhere between the brainstem and cervicothoracic spinal cord. […] The classic cause of Horners syndrome affecting the second-order neuron is a pancoast tumour. […] The most concerning cause of Horners secondary to a third-order neuron lesion is carotid artery dissection.

• #21 Horner’s Syndrome | Birth Injuries

  https://www.birthinjuryhelpcenter.org/birth-injuries/erb-s-palsy/other-nerve-injuries/horners-syndrome/

  Horners syndrome is the result of damage to the nerve connections between the brain and the eyes. […] Horners syndrome is caused by injury or damage to one of the sympathetic nerves running down either side of the face. The brain uses these nerves to control the eyes so when one of the nerves is damaged it interferes with the brains communication pathway to the eye. […] Physical trauma to a babys face during childbirth is the leading cause of facial nerve injuries resulting in Horners syndrome. About 65% of all Horners syndrome cases are connected to birth trauma. […] Another common source of trauma during childbirth that can damage facial nerves and caused Horners syndrome is the use of birth assistance instruments.

• #22 Horner syndrome: clinical perspectives | EB

  https://www.dovepress.com/horner-syndrome-clinical-perspectives-peer-reviewed-fulltext-article-EB

  Apical lung lesions that spread locally to the region of the superior thoracic outlet can cause symptoms of ipsilateral shoulder pain, paresthesias along the medial arm, forearm, and fourth and fifth digits, weakness/atrophy of the hand muscles, and a preganglionic Horner syndrome. […] Pseudomonal and staphylococcal infections, tuberculosis, aspergillosis, and cryptococcosis have also been incriminated in the pathogenesis of Pancoast syndrome. […] Injury to the brachial plexus or spinal roots, pneumothorax, fracture of the first rib, or neck hematoma are potential causes of a preganglionic Horner syndrome following trauma. […] Despite advances in neuroimaging and other diagnostic tests, as many as 28% of preganglionic Horner syndromes have no identifiable etiology. […] Lesions of the internal carotid artery classically present with unilateral head and/or neck pain, focal cerebral ischemic symptoms, and a Horner syndrome.

• #23 Horner’s Syndrome: Causes, Symptoms, and Treatments

  https://www.healthline.com/health/horners-syndrome

  Horners syndrome is a mix of symptoms that are caused when theres a disruption in the path of the nerves that run from the brain to the face. […] The general cause of Horners syndrome is damage to the nerve pathway between the brain and the face in what is called the sympathetic nervous system. […] There are three different sections of the pathway, called neurons, that may be damaged in Horners syndrome. […] The first-order neuron pathway goes from the base of the brain to the top of the spinal cord. Damage to this path may be caused by the following: trauma to the neck, stroke, tumor, diseases like multiple sclerosis that affect the neurons protective outer covering, spinal column cavity or cyst. […] The second-order neuron pathway runs from the spinal column, over the upper chest area, to the side of the neck. Damage to this path may be caused by the following: chest cavity surgery, damage to hearts main blood vessel, a tumor on the neurons protective outer covering, lung cancer, a traumatic injury.

• #24 Horner’s Syndrome

  https://mobile.fpnotebook.com/Neuro/Autonomic/HrnrsSyndrm.htm

  Paralysis of superior cervical Sympathetic Nerve […] Destructive lesion to superior cervical Ganglion […] Destruction in posterior retroparotid space […] Mediastinal tumor or superior Lung Mass […] Causes […] Vascular […] Brainstem Stroke […] Cerebral Aneurysm […] Cervical Artery Dissection […] Neurologic Conditions […] Demyelinating Disease (e.g. Multiple Sclerosis) […] Infection (Encephalitis, Meningitis) […] Posterior retroparotid space mass […] Parotid Gland tumor […] Carotid body tumor […] Metastatic tumor […] Lymphoma […] Tuberculous Adenitis […] Mediastinal Mass […] Apical Lung Lesion (e.g. Pancoast Tumor)

• #25

  https://www.healio.com/news/ophthalmology/20201008/how-and-when-should-i-workup-horner-syndrome

  A 55-year-old hypertensive man complains of acute headache on the left and is found to have a left Horner syndrome. What evaluation is necessary with Horner syndrome and how urgently should it be performed? Are there any life-threatening etiologies of a Horner syndrome? […] This patient with an acute isolated painful Horner syndrome is considered to have a left internal carotid artery dissection until proven otherwise. […] Horner syndrome may be caused by a lesion anywhere along the sympathetic pathway that supplies the head, eye, and neck. Associated symptoms and signs usually allow localization of the lesion. […] The most classic cause of central (first-order neuron) Horner is a lateral medullary infarction (Wallenberg syndrome); other causes include various thalamic, brainstem, and spinal cord lesions. Second-order Horner syndromes are most suggestive of neoplasm or trauma of the lower cervical spine, brachial plexus, or lung apex. Third-order Horner syndromes point to lesions of the internal carotid artery such as dissection or cavernous sinus aneurysms.

• #26 Horner Syndrome: Symptoms, Causes, & Treatment

  https://www.webmd.com/eye-health/horner-syndrome

  Neuroblastoma, a type of cancer, can cause Horner syndrome in some kids. It’s called congenital Horner syndrome when a baby is born with it. Only 5% of cases are congenital. […] Babies can get Horner syndrome from neck or shoulder injuries during birth. Those born with damage to their aorta, or a lack of development (agenesis) of the carotid artery, can also have it. […] In extremely rare cases, mutated genes from one parent can cause a baby to have a congenital form of the condition.

• #27 Horner’s Syndrome: Causes, Symptoms, and Treatments

  https://www.healthline.com/health/horners-syndrome

  The third-order neuron pathway runs from the neck to the skin of the face and the muscles that control the iris and eyelids. Damage to this path may be caused by the following: injury or damage to either the carotid artery or jugular vein on the side of your neck, severe headaches, including migraines and cluster headaches, infection or tumor at the base of your skull. […] The common causes for children with Horners syndrome include: neuroblastoma, which is a tumor in the hormonal and nervous systems, injury during birth to their shoulders or neck, a defect of the aorta in the heart that they are born with. […] There is also what is called idiopathic Horners syndrome. This means that the cause is unknown.

• #28 CAUSES OF HORNER SYNDROME: A STUDY OF 318 PATIENTS

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7148177/

  Some reports have indicated that, when a cause for Horner syndrome can be determined, it is most often chest and neck tumors and stroke. […] Others have suggested that Horner syndrome is more frequently caused by surgical procedures in the neck and chest. […] In the cohort of 159 apraclonidine-confirmed cases of Horner syndrome, a cause was identified in 97 (61%). […] Procedures in the neck, chest, skull base, and paraspinal region accounted for most of the identified causes, with cervical carotid dissection the next most common cause. […] In both groups, when a cause for Horner syndrome could be identified, that cause was nearly always known before the Horner syndrome was identified. […] However, in an important minority of cases, mostly involving carotid dissection or tumor, the identification of Horner syndrome was critical to the discovery of those conditions.

• #29 CAUSES OF HORNER SYNDROME: A STUDY OF 318 PATIENTS

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7148177/

  The prevalence of causes of Horner syndrome depends on the accrual method. Among pharmacologically-confirmed cases, the cause was often undetermined or due to a preceding neck or chest procedure. […] Among pharmacologically-unconfirmed cases, a substantial proportion had also been caused by neck and chest procedures, but tumors in that region were also common. […] When a cause of Horner syndrome was found in both cohorts, it was usually known before the Horner syndrome was discovered, making Horner syndrome an afterthought. […] In the pharmacologically-confirmed cohort, a cause could be determined in 97 (61%) patients. […] Among the identifiable causes in the cohort of pharmacologically-confirmed cases, neck procedures were predominant, followed by cervical carotid dissection and cluster headache.

• #30 Horner Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK500000/

  Third-order neurons are in close proximity to the internal carotid artery and cavernous sinus and are affected by the following: Carotid cavernous fistula, Internal carotid artery dissection or an aneurysm, Cluster headaches or migraines, Raeder paratrigeminal syndrome (unilateral facial pain, headache, and Horner syndrome), Herpes zoster infection, Temporal arteritis.

• #31 Horner Syndrome: Overview, Anatomy, Pathophysiology

  https://emedicine.medscape.com/article/1220091-overview

  Third-order neuron lesions that may give rise to Horner syndrome include the following: Internal carotid artery dissection (associated with sudden ipsilateral face or neck pain), Raeder syndrome (paratrigeminal syndrome) – Oculosympathetic paresis and ipsilateral facial pain with variable involvement of the trigeminal and oculomotor nerves, Carotid cavernous fistula, Cluster or migraine headache, Herpes zoster.

• #32 Horner’s Syndrome: Symptoms, Causes, and Treatment | Doctor

  https://patient.info/doctor/horners-syndrome

  Horner’s syndrome causes (Aetiology)78 […] Central (first-order) nerve lesions […] Preganglionic (second-order) nerve lesions […] Postganglionic (third-order) nerve lesions […] Cerebrovascular accidents. […] Apical lung tumours (eg, Pancoast’s tumour). […] Cluster headaches or migraine. […] Multiple sclerosis. […] Lymphadenopathy (lymphoma, leukaemia, tuberculosis, mediastinal tumours). […] Herpes zoster infection. […] Pituitary or basal skull tumours. […] Lower brachial plexus trauma or cervical rib. […] Internal carotid artery dissection, may be traumatic.910 […] Basal meningitis (eg, syphilis). […] Aneurysms of the aorta, subclavian or common carotid arteries. […] Raeder’s syndrome (paratrigeminal syndrome). […] Neck trauma (eg, cervical vertebral dislocation or dissection of the vertebral artery).

• #33 Horner syndrome: clinical perspectives | EB

  https://www.dovepress.com/horner-syndrome-clinical-perspectives-peer-reviewed-fulltext-article-EB

  Apical lung lesions that spread locally to the region of the superior thoracic outlet can cause symptoms of ipsilateral shoulder pain, paresthesias along the medial arm, forearm, and fourth and fifth digits, weakness/atrophy of the hand muscles, and a preganglionic Horner syndrome. […] Pseudomonal and staphylococcal infections, tuberculosis, aspergillosis, and cryptococcosis have also been incriminated in the pathogenesis of Pancoast syndrome. […] Injury to the brachial plexus or spinal roots, pneumothorax, fracture of the first rib, or neck hematoma are potential causes of a preganglionic Horner syndrome following trauma. […] Despite advances in neuroimaging and other diagnostic tests, as many as 28% of preganglionic Horner syndromes have no identifiable etiology. […] Lesions of the internal carotid artery classically present with unilateral head and/or neck pain, focal cerebral ischemic symptoms, and a Horner syndrome.

• #34

  https://www.healio.com/news/ophthalmology/20201008/how-and-when-should-i-workup-horner-syndrome

  An acute painful Horner syndrome should be presumed related to a dissection of the ipsilateral internal carotid artery unless proven otherwise (these patients are at risk of cerebral infarction and should be evaluated emergently). […] In many patients, especially patients with a third-order Horner syndrome, no etiology may be discovered.

• #35 CAUSES OF HORNER SYNDROME: A STUDY OF 318 PATIENTS

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7148177/

  The prevalence of causes of Horner syndrome depends on the accrual method. Among pharmacologically-confirmed cases, the cause was often undetermined or due to a preceding neck or chest procedure. […] Among pharmacologically-unconfirmed cases, a substantial proportion had also been caused by neck and chest procedures, but tumors in that region were also common. […] When a cause of Horner syndrome was found in both cohorts, it was usually known before the Horner syndrome was discovered, making Horner syndrome an afterthought. […] In the pharmacologically-confirmed cohort, a cause could be determined in 97 (61%) patients. […] Among the identifiable causes in the cohort of pharmacologically-confirmed cases, neck procedures were predominant, followed by cervical carotid dissection and cluster headache.

• #36 Horner’s Syndrome – Emianopsia

  https://www.emianopsia.com/en/horner-syndrome/

  peripheral of preganglionic origin (second neuron of the sympathetic pathway from the spinal cord to the neck): tumor of the lung (Pancoast tumor) or of the thyroid gland, presence of goiter, resulting in a mass effect, schwannoma or neuroblastoma, damage to one of the main blood vessels connecting to the heart (e.g. the aorta), surgery to the thoracic cavity, thyroidectomy (trauma or surgical damage), Klumpkes palsy with brachial plexus involvement, aneurysm or dissection of the aorta, central vein catheterization, lymphadenopathy (e.g. Hodgkins lymphoma, leukemia, tuberculosis, or mediastinal tumors), mandibular abscess, middle ear lesions. […] peripheral lesions of postganglionic origin (third neuron of the sympathetic pathway from the neck to the facial skin, iris, and eyelid muscles): internal carotid artery dissection with sudden pain, Raeder syndrome (paratrigeminal syndrome), carotid cavernous fistula, cluster headache or migraine, herpes zoster (shingles), tumor at the base of the skull, due to the mass effect, infectious disease affecting the skull, such as ear infections, migraine, cavernous sinus thrombosis, cluster headache.

• #37 Horner’s Syndrome: Causes, Symptoms And Treatment

  https://www.netmeds.com/health-library/post/horners-syndrome-causes-symptoms-and-treatment

  This neuronal pathway ranges from the spinal column, across the upper chest region and up until the side of the neck. The possible causes of a decline in nerve function in this segment comprise: Lung cancer, Wound in the aorta, which is the main blood vessel arising from the heart, Surgery in the chest cavity, Tumour of the myelin sheath i.e. schwannoma, Traumatic injury. […] This complex mesh of nerve cells begins at the side of the neck and reaches up to the facial skin, as well as muscles of the iris and eyelids. Damage to nerves in this portion of the sympathetic trunk happens due to: Injury to the carotid artery along the side of the neck, Jugular vein impairment at the side of the neck, Infection or tumour close to the base of the skull, Cluster headaches and migraines. […] In a majority of cases, Horners syndrome in children stems from the following reasons: Lesions to the neck or shoulders during delivery, Faults in the aorta at the time of birth, Tumours in the neuroendocrine system, like neuroblastoma. […] The precise cause of Horners syndrome cannot be determined in certain situations. This is termed as idiopathic Horner syndrome.

• #38 Horner’s Syndrome: Symptoms, Causes, and Treatment | Doctor

  https://patient.info/doctor/horners-syndrome

  Horner’s syndrome causes (Aetiology)78 […] Central (first-order) nerve lesions […] Preganglionic (second-order) nerve lesions […] Postganglionic (third-order) nerve lesions […] Cerebrovascular accidents. […] Apical lung tumours (eg, Pancoast’s tumour). […] Cluster headaches or migraine. […] Multiple sclerosis. […] Lymphadenopathy (lymphoma, leukaemia, tuberculosis, mediastinal tumours). […] Herpes zoster infection. […] Pituitary or basal skull tumours. […] Lower brachial plexus trauma or cervical rib. […] Internal carotid artery dissection, may be traumatic.910 […] Basal meningitis (eg, syphilis). […] Aneurysms of the aorta, subclavian or common carotid arteries. […] Raeder’s syndrome (paratrigeminal syndrome). […] Neck trauma (eg, cervical vertebral dislocation or dissection of the vertebral artery).

• #39 Horner Syndrome in Children — Pediatric EM Morsels

  https://pedemmorsels.com/horner-syndrome-in-children/

  Horner Syndrome can be Congenital or Acquired. […] Most common identifiable cause of pediatric Horner Syndrome = Birth Trauma. […] Many cases are idiopathic. […] Biggest concerns for evaluation of new-onset Horner Syndrome is Neuroblastoma. […] Children more often have 2nd order / preganglionic neurons affected. […] One important condition to keep in mind is Neuroblastoma. […] Birth Trauma leads the way. Congenital causes are likely to be mechanical stress placed on the neck/carotid sheath. […] New onset Horner Syndrome? Gotta think of neuroblastoma.

• #40 Anisocoria and Horner’s Syndrome

  https://www.aapos.org/glossary/anisocoria-and-horners-syndrome

  Horners syndrome is caused by injury to specialized nerves (the sympathetic nerves) in the brain, neck, or upper chest on the same side as the smaller pupil. […] Horners syndrome can be divided into congenital (occurring in the first 4 weeks of life) and acquired cases (those that happen after 4 weeks of life). Congenital Horners most commonly occurs from neck/shoulder trauma during childbirth. […] Acquired cases (occurring after 4 weeks of age) can be due to neck trauma, neck surgery, or a tumor or growth in the chest, neck, or brain. […] In children, Horners syndrome may be caused by a tumor called neuroblastoma. Neuroblastoma is a tumor that comes from other parts of the body and spreads to the sympathetic nerves that control the pupil.

• #41 Horner’s Syndrome, Causes, Symptoms and Treatment

  https://www.birthinjuryguide.org/birth-injury-types/horners-syndrome/

  Horner’s syndrome is a condition caused by damage to the nerve pathway that leads from the brain to the eye and face on the affected side of the body. […] There are a variety of causes to Horner’s syndrome, but infants typically develop the disorder either congenitally or via an injury during childbirth. […] Congenital Causes: Artery problems, Carotid artery ischemia, Lack of proper development of the carotid artery, Genetic, Unknown reasons. […] Birth Trauma Causes: Improper use of forceps during delivery, Failure to properly detect abnormal fetal position (breech, etc.) and deliver in time, Pulling too hard on the infant, causing tears to the sympathetic nerves, Newborn shoulder dystocia and damage to the brachial plexus-nerves that supply the neck and arms, Failure to respond to fetal distress in time, Failure to schedule and perform a cesarean section (C-section) surgery in time.

• #42 Horner’s Syndrome | Horner’s Syndrome: Awareness, Action & Advocacy Foundation

  https://hornerssyndromefoundation.com/horners-syndrome

  Horner’s Syndrome is caused by damage to the sympathetic nerves of the face. […] The underlying causes of Horner’s Syndrome vary greatly and may include a tumor, stroke, injury or underlying disease affecting the areas surrounding the sympathetic nerves. […] There are many potential causes of Horner’s Syndrome. It can be caused by any interruption in function of the sympathetic nerve fibers, which start in the hypothalamus and run via the upper spinal cord, near the carotid artery, to the face. Nerve function may be impaired due to factors such as injury, compression or a disease process. Examples of causes of Horner’s syndrome include: Birth trauma to the neck and shoulder. A stroke in the brainstem. Injury, blood clot or dissection of the carotid artery. Trauma or surgery involving the neck, upper spinal cord or chest. A tumor in the brainstem, hypothalamus, upper spinal cord, neck, eye, abdomen or chest cavity – particularly a neuroblastoma or a tumor of the upper part of the lung (Pancoast tumor). Neuroblastoma is one of the most common causes of Horner’s Syndrome in children. Migraines or cluster headaches. Diseases that cause damage to the protective covering that surrounds nerve fibers (demyelinating diseases). Development of a fluid-filled cavity or cyst within the spinal cord (syringomyelia). Arnold-Chiari malformation. Inflammation or growths that affect the lymph nodes of the neck.

• #43 Horner syndrome: MedlinePlus GeneticsLock

  https://medlineplus.gov/genetics/condition/horner-syndrome/

  Horner syndrome is a disorder that affects the eye and surrounding tissues on one side of the face and results from paralysis of certain nerves. […] Horner syndrome that appears after the newborn period (acquired Horner syndrome) and most cases of congenital Horner syndrome result from damage to nerves called the cervical sympathetics. […] Damage to the cervical sympathetic nerves can be caused by a direct injury to the nerves themselves, which can result from trauma that might occur during a difficult birth, surgery, or accidental injury. […] Horner syndrome can also be caused by problems with the artery that supplies blood to the head and neck (the carotid artery) on the affected side, resulting in loss of blood flow to the nerves. […] Some individuals with congenital Horner syndrome have a lack of development (agenesis) of the carotid artery.

• #44 Horner syndrome: clinical perspectives | EB

  https://www.dovepress.com/horner-syndrome-clinical-perspectives-peer-reviewed-fulltext-article-EB

  Internal carotid artery lesions other than dissections that are associated with a Horner syndrome include aneurysms, severe atherosclerosis, acute thrombosis, fibromuscular dysplasia, EhlerDanlos syndrome, Marfan syndrome, and arteritis. […] Damage to the superior cervical ganglion can cause a postganglionic Horner syndrome as the ganglion lies about 1.5 cm behind the palatine tonsil and can be damaged by traumatic penetrating intraoral injury or even procedures such as tonsillectomies, intraoral surgery, and peritonsillar injections. […] The causes of Horner syndrome in children are usually classified as congenital or acquired. […] In a large study of 73 pediatric patients, 42% were noted to be congenital in nature, and 42% were acquired after a surgical procedure involving the thorax, neck, or central nervous system. […] Neuroblastoma is the most common occult malignancy associated with Horner syndrome, with an incidence of one in 7,000 children younger than the age of 5 years. […] The etiologies of Horner syndrome are numerous, with some being life-threatening.

• #45

  https://journals.lww.com/ijo/fulltext/2006/54030/congenital_horner_s_syndrome_and_the_usefulness_of.11.aspx

  We present a seven-month-old baby with miosis of the left pupil, left hypochromia, mild ipsilateral ptosis, left hemifacial anhidrosis and asymmetrical facial flushing. A diagnosis of Horner’s syndrome (HS) was presumed and was confirmed by instillation of apraclonidine eye drops. […] Although delivery-related brachial plexus injury is known as the most common cause of congenital HS, it should be investigated and should include neuroimaging of the sympathetic pathway, to exclude a serious underlying disease. […] Congenital HS is most commonly idiopathic or due to birth trauma. […] Delivery-related brachial plexus injury is known as the most common cause of HS. However, any lesion along the sympathetic chain may result in HS. Of considerable importance is primary thoracic and cervical neuroblastoma, where timely diagnosis is crucial.

• #46 Horner Syndrome – EyeWiki

  https://eyewiki.org/Horner_Syndrome

  Preganglionic (second order neuron) Horner’s: These include lesions of the thoracic outlet (cervical rib, subclavian artery aneurysm), mediastinum (mediastinal tumors), pulmonary apex (Pancoast’s tumor), neck (thyroid malignancies) or the thoracic spinal cord (trauma) or surgical procedures in this region including radical neck dissection, jugular vein cannulation, thoracoscopy or mediastinoscopy, chest tube placement and other thoracic surgical procedures. […] Third order neuron or postganglionic lesion: These include lesions of the superior cervical ganglion (trauma, radical neck dissection or jugular vein ectasia), lesions of the internal carotid artery (ICA) in the neck and skull base (dissection, thrombosis, invasion by tumors or iatrogenic from endarterectomy or stenting, base of skull malignancies), lesions of ICA in the cavernous sinus (thrombosis, aneurysm, inflammation or invasive tumors) and lesions of the sellar and parasellar regions (invasive pituitary tumors, metastatic tumors, paratrigeminal tumors). Other causes include cluster headaches. […] In children, trauma (birth trauma or neck trauma) is the most common cause of Horner’s syndrome. […] Other causes include surgical trauma, neuroblastoma, brainstem lesions (such as vascular malformations, glioma and demyelination) and carotid artery thrombosis.

• #47 Traumatic Horner Syndrome – EyeWiki

  https://eyewiki.org/Traumatic_Horner_Syndrome

  While some trauma may be obvious, dissections of the internal carotid artery and resultant Horner syndrome may occur with seemingly minor trauma. […] Traumatic Horner syndrome in the pediatric patient may occur due to birth trauma or complicated deliveries. However, when faced with a child with Horner syndrome, the primary focus should be ruling out thoracic and cervical neuroblastoma. […] Although there are many causes of Horner syndrome, head, neck, and chest trauma can precipitate the syndrome.

• #48 Horner Syndrome – EyeWiki

  https://eyewiki.org/Horner_Syndrome

  Preganglionic (second order neuron) Horner’s: These include lesions of the thoracic outlet (cervical rib, subclavian artery aneurysm), mediastinum (mediastinal tumors), pulmonary apex (Pancoast’s tumor), neck (thyroid malignancies) or the thoracic spinal cord (trauma) or surgical procedures in this region including radical neck dissection, jugular vein cannulation, thoracoscopy or mediastinoscopy, chest tube placement and other thoracic surgical procedures. […] Third order neuron or postganglionic lesion: These include lesions of the superior cervical ganglion (trauma, radical neck dissection or jugular vein ectasia), lesions of the internal carotid artery (ICA) in the neck and skull base (dissection, thrombosis, invasion by tumors or iatrogenic from endarterectomy or stenting, base of skull malignancies), lesions of ICA in the cavernous sinus (thrombosis, aneurysm, inflammation or invasive tumors) and lesions of the sellar and parasellar regions (invasive pituitary tumors, metastatic tumors, paratrigeminal tumors). Other causes include cluster headaches. […] In children, trauma (birth trauma or neck trauma) is the most common cause of Horner’s syndrome. […] Other causes include surgical trauma, neuroblastoma, brainstem lesions (such as vascular malformations, glioma and demyelination) and carotid artery thrombosis.

• #49

  https://journals.lww.com/ijo/fulltext/2006/54030/congenital_horner_s_syndrome_and_the_usefulness_of.11.aspx

  Other reported causes of congenital HS are agenesis of the internal carotid artery, complication of various surgical procedures involving the thorax and the neck, carotid artery aneurysm and traumatic carotid dissection. […] In conclusion, although delivery-related brachial plexus injury is known as the most common cause of congenital HS, imaging of the entire sympathetic pathway is warranted, since life-threatening malignancy and abnormalities may be revealed.

• #50

  https://journals.lww.com/jneuro-ophthalmology/fulltext/2020/09000/causes_of_horner_syndrome__a_study_of_318_patients.12.aspx

  Some reports have indicated that when a cause for Horner syndrome can be determined, it is most often chest and neck tumors and stroke. […] Others have suggested that Horner syndrome is more frequently caused by surgical procedures in the neck and chest. […] In the cohort of 159 apraclonidine-confirmed cases of Horner syndrome, a cause was identified in 97 (61%). Procedures in the neck, chest, skull base, and paraspinal region accounted for most of the identified causes, with cervical carotid dissection the next most common cause. […] In both groups, when a cause for Horner syndrome could be identified, that cause was nearly always known before Horner syndrome was identified. […] However, in an important minority of cases, mostly involving carotid dissection or tumor, the identification of Horner syndrome was critical to the discovery of those conditions.

• #51

  https://journals.lww.com/jneuro-ophthalmology/fulltext/2020/09000/causes_of_horner_syndrome__a_study_of_318_patients.12.aspx

  The prevalence of causes of Horner syndrome depends on the accrual method. Among pharmacologically-confirmed cases, the cause was often undetermined or due to a preceding neck or chest procedure. […] Among pharmacologically-unconfirmed cases, a substantial proportion had also been caused by neck and chest procedures, but tumors in that region were also common. […] A 1958 study of 216 patients, based on discharge summaries, found that tumors often malignant and mostly in the chest and neck were responsible for more than one-third of cases. […] A more recent study drawn from the outpatient and inpatient examinations of a single neuro-ophthalmologist found that a procedure on the neck and chest was the most commonly identified cause of Horner syndrome, followed by stroke and tumor. […] Among the identifiable causes in the cohort of pharmacologically-confirmed cases, neck procedures were predominant, followed by cervical carotid dissection and cluster headache.

• #52 CAUSES OF HORNER SYNDROME: A STUDY OF 318 PATIENTS

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7148177/

  Some reports have indicated that, when a cause for Horner syndrome can be determined, it is most often chest and neck tumors and stroke. […] Others have suggested that Horner syndrome is more frequently caused by surgical procedures in the neck and chest. […] In the cohort of 159 apraclonidine-confirmed cases of Horner syndrome, a cause was identified in 97 (61%). […] Procedures in the neck, chest, skull base, and paraspinal region accounted for most of the identified causes, with cervical carotid dissection the next most common cause. […] In both groups, when a cause for Horner syndrome could be identified, that cause was nearly always known before the Horner syndrome was identified. […] However, in an important minority of cases, mostly involving carotid dissection or tumor, the identification of Horner syndrome was critical to the discovery of those conditions.

• #53

  https://journals.lww.com/jneuro-ophthalmology/fulltext/2020/09000/causes_of_horner_syndrome__a_study_of_318_patients.12.aspx

  Among the pharmacologically-unconfirmed cases, procedures again accounted for the highest proportion of causes, but tumors in the oculosympathetic pathway were the second most frequent cause. […] Carotid dissection was the second most common identifiable cause of Horner syndrome in our study. […] When a cause could be determined in our cohorts, the examiner making the diagnosis of Horner syndrome already knew that cause in most cases, making the Horner diagnosis often an afterthought.

• #54 Shedding light on Horner syndrome

  https://www.ophthalmologytimes.com/view/shedding-light-on-horner-syndrome

  Horner syndrome is characterized by ipsilateral ptosis, miosis, and anhidrosis that result from a lesion affecting the oculosympathetic pathway. The syndrome can be benign if idiopathic or iatrogenic but can be predictive of a life-threatening event such as demyelinating inflammatory, infectious, vascular, or neoplastic problems. […] According to the team of investigators, the causes varied widely from those that were benign including idiopathic and surgical causes, cluster headache, and goiter to the neurologically or systemically dangerous causes that included carotid artery dissection, stroke, neoplastic and traumatic causes, varicella zoster, arteriovenous fistula, and fibromuscular dysplasia. […] The most common etiologies were idiopathic (20 patients, 25.6%), followed by internal carotid artery (ICA) dissection (15 patients, 19.2%), stroke (12 patients, 15.4%), surgical (12 patients, 15.4%), and neoplastic (11.5%). Analysis of the etiologies indicated that about 56% of cases had a dangerous neurologic or systemic origin, according to investigators.

• #55 CAUSES OF HORNER SYNDROME: A STUDY OF 318 PATIENTS

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7148177/

  Stroke and tumor accounted for a small proportion of cases. […] Among the pharmacologically-unconfirmed cases, procedures again accounted for the highest proportion of causes, but tumors in the oculosympathetic pathway were the second most frequent cause. […] Carotid dissection was the second most common identifiable cause of Horner syndrome in our study. […] Cluster headache accounted for about 10% of causes in our study. […] Stroke was an infrequent cause of Horner syndrome in our study. […] Trauma, mostly to the neck, accounted for an important proportion of Horner syndrome in our study, as it has in other studies. […] The difference in the prevalence of tumor among pharmacologically-confirmed and pharmacologically-unconfirmed Horner syndrome in our study is striking but easily explainable by accrual methods. […] When a cause could be determined in our cohorts, the examiner making the diagnosis of Horner syndrome already knew that cause in most cases, making the Horner diagnosis often an afterthought.

• #56 CAUSES OF HORNER SYNDROME: A STUDY OF 318 PATIENTS

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7148177/

  Stroke and tumor accounted for a small proportion of cases. […] Among the pharmacologically-unconfirmed cases, procedures again accounted for the highest proportion of causes, but tumors in the oculosympathetic pathway were the second most frequent cause. […] Carotid dissection was the second most common identifiable cause of Horner syndrome in our study. […] Cluster headache accounted for about 10% of causes in our study. […] Stroke was an infrequent cause of Horner syndrome in our study. […] Trauma, mostly to the neck, accounted for an important proportion of Horner syndrome in our study, as it has in other studies. […] The difference in the prevalence of tumor among pharmacologically-confirmed and pharmacologically-unconfirmed Horner syndrome in our study is striking but easily explainable by accrual methods. […] When a cause could be determined in our cohorts, the examiner making the diagnosis of Horner syndrome already knew that cause in most cases, making the Horner diagnosis often an afterthought.

• #57 CAUSES OF HORNER SYNDROME: A STUDY OF 318 PATIENTS

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7148177/

  Stroke and tumor accounted for a small proportion of cases. […] Among the pharmacologically-unconfirmed cases, procedures again accounted for the highest proportion of causes, but tumors in the oculosympathetic pathway were the second most frequent cause. […] Carotid dissection was the second most common identifiable cause of Horner syndrome in our study. […] Cluster headache accounted for about 10% of causes in our study. […] Stroke was an infrequent cause of Horner syndrome in our study. […] Trauma, mostly to the neck, accounted for an important proportion of Horner syndrome in our study, as it has in other studies. […] The difference in the prevalence of tumor among pharmacologically-confirmed and pharmacologically-unconfirmed Horner syndrome in our study is striking but easily explainable by accrual methods. […] When a cause could be determined in our cohorts, the examiner making the diagnosis of Horner syndrome already knew that cause in most cases, making the Horner diagnosis often an afterthought.

• #58 Horner Syndrome – EyeWiki

  https://eyewiki.org/Horner_Syndrome

  Horner’s syndrome (also called oculosympathetic paresis, or Horner syndrome) comprises a constellation of clinical signs including the classic triad of ptosis, miosis, and anhidrosis. It results from a lesion to the sympathetic pathway that supplies the head and neck region. The cause of Horner’s syndrome varies with the site of the lesion. Prompt evaluation is necessary to detect and treat potentially life-threatening conditions. […] The etiology of Horner’s syndrome varies with the patient age and site of lesion. The etiology remains unknown in 35-40% of cases. […] Central (first order neuron) Horner’s: These include lesions of the hypothalamus, brainstem and spinal cord such as stroke (classically the lateral medullary syndrome), demyelination (such as multiple sclerosis), neoplasms (such as glioma), or other processes such as a syrinx (syringomyelia or syringobulbia).

• #59 Horner syndrome: MedlinePlus GeneticsLock

  https://medlineplus.gov/genetics/condition/horner-syndrome/

  Tearing of the layers of the carotid artery wall (carotid artery dissection) can also lead to Horner syndrome. […] Some people with Horner syndrome have neither a known problem that would lead to nerve damage nor any history of the disorder in their family. These cases are referred to as idiopathic Horner syndrome.

• #60 CAUSES OF HORNER SYNDROME: A STUDY OF 318 PATIENTS

  https://pmc.ncbi.nlm.nih.gov/articles/PMC7148177/

  Some reports have indicated that, when a cause for Horner syndrome can be determined, it is most often chest and neck tumors and stroke. […] Others have suggested that Horner syndrome is more frequently caused by surgical procedures in the neck and chest. […] In the cohort of 159 apraclonidine-confirmed cases of Horner syndrome, a cause was identified in 97 (61%). […] Procedures in the neck, chest, skull base, and paraspinal region accounted for most of the identified causes, with cervical carotid dissection the next most common cause. […] In both groups, when a cause for Horner syndrome could be identified, that cause was nearly always known before the Horner syndrome was identified. […] However, in an important minority of cases, mostly involving carotid dissection or tumor, the identification of Horner syndrome was critical to the discovery of those conditions.

• #61 Horner syndrome | MedLink Neurology

  https://www.medlink.com/articles/horner-syndrome

  Although many of the causes of acquired Horner syndrome in children are similar to those in adults, most have no identifiable etiology. […] When Horner syndrome is discovered in hospitalized adult patients, the predominant causes will be neck, chest, and paraspinal tumors, trauma, and procedures, especially internal jugular venous cannulation. […] In chronic isolated Horner syndrome in adults, imaging is often negative but must be performed to rule out tumors.

• #62

  https://www.healio.com/news/ophthalmology/20201008/how-and-when-should-i-workup-horner-syndrome

  An acute painful Horner syndrome should be presumed related to a dissection of the ipsilateral internal carotid artery unless proven otherwise (these patients are at risk of cerebral infarction and should be evaluated emergently). […] In many patients, especially patients with a third-order Horner syndrome, no etiology may be discovered.

• #63 Horner’s Syndrome in Cats: Causes, Symptoms, & Treatment

  https://www.animaleyeguys.com/site/blog/2023/09/15/horner-syndrome-cats

  Horner’s syndrome is a neurological disorder that affects the muscles around the eyes and face. It’s caused by a dysfunction the the sympathetic nervous system. […] Both the sympathetic and parasympathetic systems can affect the pupil, making it impossible for the eye muscles to contract and relax. Some of the triggers can include: […] Trauma: Injuries to the spine, neck, or head can lead to Horners syndrome. this trauma can occur from various sources, such as car accidents, bite wounds from another animal, or certain surgeries like thoracic surgeries. […] Tumors: A tumor can affect the nerve fibers in the brain, brain stem, or spinal cord. […] Blood clots: An abnormal blood clot (infarction) in the spinal cord may cause a lesion that affects typical function and causes Horners syndrome.

• #64 Horner Syndrome – Brain, Spinal Cord, and Nerve Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/brain-spinal-cord-and-nerve-disorders/autonomic-nervous-system-disorders/horner-syndrome

  Horner syndrome may occur on its own or result from a disorder that disrupts nerve fibers connecting the brain with the eye. […] The cause, if identified, is treated. […] Some of the nerve fibers that connect the eyes and brain take a circuitous route. From the brain, they go down the spinal cord. They exit the spinal cord in the chest, then go back up the neck beside the carotid artery, through the skull, and into the eye. If these nerve fibers are disrupted anywhere along their pathway, Horner syndrome results. […] Horner syndrome may occur on its own or be caused by another disorder. For example, it can be caused by disorders of the head, brain, neck, chest, or spinal cord, such as the following: Lung cancer, Other tumors, Swollen lymph glands in the neck (cervical adenopathy), Dissection of the aorta or carotid artery (a tear in the lining of the artery’s wall), A thoracic aortic aneurysm (a bulge in the aorta’s wall), Injuries.

• #65 Horner syndrome: clinical perspectives | EB

  https://www.dovepress.com/horner-syndrome-clinical-perspectives-peer-reviewed-fulltext-article-EB

  Horner syndrome consists of unilateral ptosis, an ipsilateral miotic but normally reactive pupil, and in some cases, ipsilateral facial anhidrosis, all resulting from damage to the ipsilateral oculosympathetic pathway. […] The disruption of sympathetic innervation to the eye gives rise to a constellation of symptoms consisting of miosis, ptosis, and anhidrosis. […] Lesions of the hypothalamus, such as tumor or hemorrhage, can cause an ipsilateral Horner syndrome with contralateral hemiparesis and contralateral hypesthesia. […] In a series of 450 patients with Horner syndrome, 270 (65%) were found to have an identifiable cause. […] Of the patients with a detectible etiology, 13% had a central lesion, 44% had a preganglionic lesion, and 43% had a postganglionic lesion. […] The most common tumors were lung and breast cancer.

• #66

  https://www.healio.com/news/ophthalmology/20201008/how-and-when-should-i-workup-horner-syndrome

  A 55-year-old hypertensive man complains of acute headache on the left and is found to have a left Horner syndrome. What evaluation is necessary with Horner syndrome and how urgently should it be performed? Are there any life-threatening etiologies of a Horner syndrome? […] This patient with an acute isolated painful Horner syndrome is considered to have a left internal carotid artery dissection until proven otherwise. […] Horner syndrome may be caused by a lesion anywhere along the sympathetic pathway that supplies the head, eye, and neck. Associated symptoms and signs usually allow localization of the lesion. […] The most classic cause of central (first-order neuron) Horner is a lateral medullary infarction (Wallenberg syndrome); other causes include various thalamic, brainstem, and spinal cord lesions. Second-order Horner syndromes are most suggestive of neoplasm or trauma of the lower cervical spine, brachial plexus, or lung apex. Third-order Horner syndromes point to lesions of the internal carotid artery such as dissection or cavernous sinus aneurysms.

• #67

  https://www.healio.com/news/ophthalmology/20201008/how-and-when-should-i-workup-horner-syndrome

  An acute painful Horner syndrome should be presumed related to a dissection of the ipsilateral internal carotid artery unless proven otherwise (these patients are at risk of cerebral infarction and should be evaluated emergently). […] In many patients, especially patients with a third-order Horner syndrome, no etiology may be discovered.

• #68 Horner Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK500000/

  Horner syndrome is primarily an acquired condition secondary to systemic/local diseases or iatrogenic causes but may be congenital and purely hereditary in some rare cases. […] Sympathetic fibers have an extensive course and can be interrupted during extracranial, intracranial, or intra-orbital traversal. […] The sympathetic fibers may be interrupted centrally, between the hypothalamus and the exit point of fibers from the spinal cord (C8 to T2), or the discontinuation could be peripheral, in the cervical sympathetic chain, at the level of superior cervical ganglion, or along the course of the carotid artery. […] Preganglionic Horner syndrome can be an ominous sign due to its association with pulmonary malignancies. […] Overall, the causes of Horner syndrome can be divided according to the anatomical location of disruption.

• #69 Horner’s Syndrome: Symptoms, Causes, and Treatment | Doctor

  https://patient.info/doctor/horners-syndrome

  Trauma or surgical injury (neck or chest).11 […] Carotid-cavernous fistula. […] Syringomyelia. […] Neuroblastoma. […] Temporal arteritis12 […] Arnold-Chiari malformation. […] Mandibular dental abscess. […] Spinal cord tumours. […] Horner’s syndrome associated with pain always needs investigation. If there is arm, shoulder or hand pain think of Pancoast’s syndrome. If pain is in the face or neck, think of carotid dissection. Pain and transient visual loss may be due to carotid dissection3 . […] In children, unless there is a known aetiology such as birth trauma, acquired Horner’s syndrome requires thorough investigation; there is frequently a serious underlying cause, including neuroblastoma, trauma, rhabdomyosarcoma and brainstem vascular malformation13 . […] A rare congenital form of Horner’s syndrome is described6 . It may present as an autosomal dominant condition or as a spontaneous mutation. […] Preganglionic lesions are less common but are more likely to be malignant.

• #70

  https://journals.lww.com/jneuro-ophthalmology/fulltext/2020/09000/causes_of_horner_syndrome__a_study_of_318_patients.12.aspx

  Some reports have indicated that when a cause for Horner syndrome can be determined, it is most often chest and neck tumors and stroke. […] Others have suggested that Horner syndrome is more frequently caused by surgical procedures in the neck and chest. […] In the cohort of 159 apraclonidine-confirmed cases of Horner syndrome, a cause was identified in 97 (61%). Procedures in the neck, chest, skull base, and paraspinal region accounted for most of the identified causes, with cervical carotid dissection the next most common cause. […] In both groups, when a cause for Horner syndrome could be identified, that cause was nearly always known before Horner syndrome was identified. […] However, in an important minority of cases, mostly involving carotid dissection or tumor, the identification of Horner syndrome was critical to the discovery of those conditions.

• #71 Horner’s Syndrome: Symptoms, Causes, and Treatment | Doctor

  https://patient.info/doctor/horners-syndrome

  Trauma or surgical injury (neck or chest).11 […] Carotid-cavernous fistula. […] Syringomyelia. […] Neuroblastoma. […] Temporal arteritis12 […] Arnold-Chiari malformation. […] Mandibular dental abscess. […] Spinal cord tumours. […] Horner’s syndrome associated with pain always needs investigation. If there is arm, shoulder or hand pain think of Pancoast’s syndrome. If pain is in the face or neck, think of carotid dissection. Pain and transient visual loss may be due to carotid dissection3 . […] In children, unless there is a known aetiology such as birth trauma, acquired Horner’s syndrome requires thorough investigation; there is frequently a serious underlying cause, including neuroblastoma, trauma, rhabdomyosarcoma and brainstem vascular malformation13 . […] A rare congenital form of Horner’s syndrome is described6 . It may present as an autosomal dominant condition or as a spontaneous mutation. […] Preganglionic lesions are less common but are more likely to be malignant.

• #72

  https://journals.lww.com/ijo/fulltext/2006/54030/congenital_horner_s_syndrome_and_the_usefulness_of.11.aspx

  Other reported causes of congenital HS are agenesis of the internal carotid artery, complication of various surgical procedures involving the thorax and the neck, carotid artery aneurysm and traumatic carotid dissection. […] In conclusion, although delivery-related brachial plexus injury is known as the most common cause of congenital HS, imaging of the entire sympathetic pathway is warranted, since life-threatening malignancy and abnormalities may be revealed.

• #73

  https://journals.lww.com/jneuro-ophthalmology/fulltext/2020/09000/causes_of_horner_syndrome__a_study_of_318_patients.12.aspx

  The prevalence of causes of Horner syndrome depends on the accrual method. Among pharmacologically-confirmed cases, the cause was often undetermined or due to a preceding neck or chest procedure. […] Among pharmacologically-unconfirmed cases, a substantial proportion had also been caused by neck and chest procedures, but tumors in that region were also common. […] A 1958 study of 216 patients, based on discharge summaries, found that tumors often malignant and mostly in the chest and neck were responsible for more than one-third of cases. […] A more recent study drawn from the outpatient and inpatient examinations of a single neuro-ophthalmologist found that a procedure on the neck and chest was the most commonly identified cause of Horner syndrome, followed by stroke and tumor. […] Among the identifiable causes in the cohort of pharmacologically-confirmed cases, neck procedures were predominant, followed by cervical carotid dissection and cluster headache.

• #74 Shedding light on Horner syndrome

  https://www.ophthalmologytimes.com/view/shedding-light-on-horner-syndrome

  Horner syndrome is characterized by ipsilateral ptosis, miosis, and anhidrosis that result from a lesion affecting the oculosympathetic pathway. The syndrome can be benign if idiopathic or iatrogenic but can be predictive of a life-threatening event such as demyelinating inflammatory, infectious, vascular, or neoplastic problems. […] According to the team of investigators, the causes varied widely from those that were benign including idiopathic and surgical causes, cluster headache, and goiter to the neurologically or systemically dangerous causes that included carotid artery dissection, stroke, neoplastic and traumatic causes, varicella zoster, arteriovenous fistula, and fibromuscular dysplasia. […] The most common etiologies were idiopathic (20 patients, 25.6%), followed by internal carotid artery (ICA) dissection (15 patients, 19.2%), stroke (12 patients, 15.4%), surgical (12 patients, 15.4%), and neoplastic (11.5%). Analysis of the etiologies indicated that about 56% of cases had a dangerous neurologic or systemic origin, according to investigators.

• #75 Shedding light on Horner syndrome

  https://www.ophthalmologytimes.com/view/shedding-light-on-horner-syndrome

  Fairbanks went on to note that in isolated Horner Syndrome cases, pain suggested both a dangerous etiology and a positive imaging result, which was driven primarily by patients found to have an ICA dissection. […] Finally, investigators noted that pain reported by patients suggested a dangerous etiology and positive imaging, which in this study was most likely secondary to an ICA dissection.

• #76 Azthena logo with the word Azthena

  https://www.news-medical.net/health/What-is-Horner-Syndrome.aspx

  Horner syndrome is a set of symptoms affecting the eye which is thought to occur due to damage of the sympathetic nerve supply to the eye. […] The condition is thought to be caused by disruption in the sympathetic nerve supply as a result of nerve damage. […] Research has found that Horner syndrome is most often the result of local or systemic disease, or may be caused by some forms of treatment. It is sometimes congenital: individuals are born with the condition, or more rarely inherit it. in some cases patients develop the condition because of trauma, or it is acquired secondary to another disease. No cause can be found in some patients. […] Since the sympathetic nerves traverse a long pathway, they may be damaged during their intracranial, extracranial or intra-orbital course. […] If damage occurs at any point along this path, then Horner syndrome may occur. The specific cause of the syndrome is thus linked to the anatomical area of disruption.

• #77 Azthena logo with the word Azthena

  https://www.news-medical.net/health/What-is-Horner-Syndrome.aspx

  The presence of Horner syndrome does not typically lead to loss of vision or damage to the eye, but may instead be evidence of damage to structures through which the nerve passes. Therefore, it is vital to identify the location of the damage and its cause, as the underlying issue may be serious. For example, a tumor in the lung and a stroke in the brain are just two conditions that have been linked to the cause of the syndrome.

• #78 Horner’s Syndrome: Symptoms, Causes, & Treatment – BuzzRx

  https://www.buzzrx.com/blog/horners-syndrome-symptoms-causes-and-treatment

  Horner syndrome can occur due to damage to the nerve pathways that go from the side of the neck to the skin of the face and eye muscles on one side. This can happen due to a carotid artery dissection, carotid artery aneurysm, damage to the jugular vein, skull base tumors or infections, middle ear infections, temporal arteritis, shingles, migraines, or cluster headaches. […] Horner syndrome commonly occurs in children due to an injury to the neck and shoulders during childbirth, congenital defects of the aorta, and neuroblastomas (tumors of the endocrine and nervous systems). […] According to the National Organization for Rare Disorders, Horner syndrome is sometimes passed down in families. However, it is usually an acquired disorder that develops due to non-genetic factors. The Department of Health and Human Services says that substance abuse of alcohol or illegal drugs such as cocaine and methamphetamines can also cause pupillary mydriasis and mimic Horner syndrome. […] Sometimes, the underlying causes of Horner syndrome cannot be identified. In such cases, the disorder is called idiopathic Horner syndrome.

• #79 An atypical Horner syndrome | Neurology perspectives

  https://www.elsevier.es/en-revista-neurology-perspectives-17-articulo-an-atypical-horner-syndrome-S2667049622000308

  We suspected a post-traumatic Horner syndrome due to the presence of a cervical emphysema with no carotid damage, probably due to compression of third-level neurons rather than direct neuronal injury, because of the rapid recovery after conservative treatment. Despite it being a rare condition, this phenomenon has been reported previously without vascular damage, although with different pathological mechanisms. The case-reports described in the literature are due to different etiologies, such as: penetrating cervical injury, severe retching, fracture of the first rib or have been described as a post-surgical complication, specially in relation to otorhinolaryngology, thoracic and cervical spine surgeries. […] This clinical report highlights the importance of always considering a vascular emergency and suspecting carotid dissection until proven otherwise in the case of a post-traumatic Horner syndrome, even with minor trauma such as cervical manipulations or jerky head movements due to the proximity of the internal carotid to the sympathetic system, as the management of the disease changes according to the etiology of the syndrome.

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