What is the role of imaging studies in the diagnosis of Horner syndrome?

Updated: May 01, 2019
  • Author: Christopher M Bardorf, MD, MS; Chief Editor: Edsel Ing, MD, MPH, FRCSC  more...
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Imaging studies may be ordered in conjunction with appropriate medical or surgical consultation, depending on the localization and suspected etiology. [20]

A chest radiograph should be obtained; apical bronchogenic carcinoma is the most common cause of Horner syndrome. If stroke is suspected, computed tomography (CT) of the head should be performed.

Painful Horner syndrome should alert the physician to the possibility of carotid artery dissection, and the patient should undergo further testing (ie, magnetic resonance imaging [MRI]/magnetic resonance angiography [MRA] of the brain and neck) to exclude this possibility. Internal carotid artery dissection is life-threatening and carries a risk that the patient will experience a disabling stroke.

Ultrasonography may be considered but has not been found to be reliable for diagnosing carotid artery dissection in patients with isolated Horner syndrome. [21]

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