Luc Crevits1, Katharina D'Herde2, Karel Deblaere3. 1. Department of Neurology, Ghent University Hospital, De Pintelaan 185, 9000 , Ghent, Belgium. luc.crevits@ugent.be. 2. Department of Anatomy and Embryology, Ghent University, Ghent, Belgium. 3. Department of Radiology, Ghent University Hospital, Ghent, Belgium.
Abstract
PURPOSE: To alert ophthalmologists to the possibility of brainstem ischaemia in patients with isolated Horner's syndrome. DESIGN: Observational case report. METHODS: Neuro-ophthalmological and neuroimaging assessment of a 59-year-old woman presenting with an isolated Horner's syndrome after an episode of headache. RESULTS: Horner's syndrome was pharmacologically localised to a first- or second-order sympathetic neuron on the right. Magnetic resonance imaging (MRI) showed a small ischaemic lesion at the transition between pons and midbrain, lateral to the anterolateral system involving the sympathetic tract on the right side. CONCLUSION: An isolated Horner's syndrome may be the presenting sign of a brainstem infarction. This case report stresses the importance of a rational approach to Horner's syndrome and the need to order accurate MRI.
PURPOSE: To alert ophthalmologists to the possibility of brainstem ischaemia in patients with isolated Horner's syndrome. DESIGN: Observational case report. METHODS: Neuro-ophthalmological and neuroimaging assessment of a 59-year-old woman presenting with an isolated Horner's syndrome after an episode of headache. RESULTS:Horner's syndrome was pharmacologically localised to a first- or second-order sympathetic neuron on the right. Magnetic resonance imaging (MRI) showed a small ischaemic lesion at the transition between pons and midbrain, lateral to the anterolateral system involving the sympathetic tract on the right side. CONCLUSION: An isolated Horner's syndrome may be the presenting sign of a brainstem infarction. This case report stresses the importance of a rational approach to Horner's syndrome and the need to order accurate MRI.