Horner syndrome

Background

• Involves lesion anywhere along the sympathetic tract:
  • Central (Hypothalamus, brainstem, spinal cord)
  • Preganglionic (Pulmonary apex)
  • Postganglionic (Superior cervical ganglion, ICA, skull base, cavernous sinus)
• Etiology
  • Adults: CVA, tumor, ICA dissection, zoster, trauma
  • Peds: Neuroblastoma, lymphoma, mets

Clinical Features

• Ipsilateral ptosis, miosis, anhydrosis
• Neck pain suggest carotid dissection

Diagnosis

• CXR
• CT brain