Horner's syndrome causes

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Horner's syndrome is usually acquired but may also be congenital (inborn) or iatrogenic (caused by medical treatment). Although most causes are relatively benign, Horner's syndrome may reflect serious pathology in the neck or chest (such as a Pancoast tumor or thyrocervical venous dilatation) and hence requires workup.

Common Causes

• Due to lesion of one side of the cervical sympathetic chain which affects on the same side of the lesion
• PICA syndrome
• Cluster headache - combination termed Horton's headache
• Trauma - base of neck, usually blunt trauma.
• Middle ear infection
• Tumors - often bronchogenic carcinoma of the superior fissure (Pancoast tumor)
• Thoracic aortic aneurysm
• Neurofibromatosis type 1
• Goitre
• Dissecting aortic aneurysm
• Thyroid carcinoma
• Multiple sclerosis
• Carotid artery dissection
• Klumpke paralysis
• Cavernous sinus thrombosis
• Sympathectomy
• Syringomyelia
• Nerve blocks, such as cervical plexus block, stellate ganglion or interscalene block
• Brainstem stroke
• Carotid body tumor
• Lymphoma
• Mediastinal mass
• Metastasis
• Parotid gland tumor
• Tuberculosis adenitis

Causes by Organ System

Cardiovascular	Aneurysm or dissection of the aorta, Aortic aneurysm thoracic, Carotid aneurysm, Carotid angiography, Carotid artery dissection, Carotid artery thrombosis, Carotid cavernous, fistula, Cavernous sinus Inflammation, Coronary artery bypass grafting, Dissecting aortic aneurysm, Internal carotid artery, Aneurysm , Internal carotid artery Arteritis, Internal carotid artery Dissection, Lesions of the subclavian or common carotid artery, Subclavian artery aneurysm, Thoracic Aortic aneurysm
Chemical/Poisoning	No underlying causes
Dental	No underlying causes
Dermatologic	No underlying causes
Drug Side Effect	No underlying causes
Ear Nose Throat	Acute otitis media, Lesions of the middle ear, Middle ear infection
Endocrine	Goitre, Invasive pituitary tumor
Environmental	No underlying causes
Gastroenterologic	No underlying causes
Genetic	Arnold-Chiari malformation, Neurofibromatosis type 1
Hematologic	Leukemia, Cavernous sinus thrombosis, Internal carotid artery Thrombosis, Lymphadenopathy, Lymphoma
Iatrogenic	Central venous catheterization, Cervical plexus block, Chest tube placement, Interscalene block, Jugular cannulation, Neck surgery, Radical neck dissection, Stellate ganglion block, Sympathectomy, Thoracic surgery, Thyroidectomy, Traumatic dissection of the vertebral artery
Infectious Disease	Basal meningitis, Congenital infections, Herpes zoster, Hydatid cyst, Mandibular tooth abscess, Tuberculosis, Tuberculosis adenitis
Musculoskeletal/Orthopedic	No underlying causes
Neurologic	Brain stem Demyelination, Brain stem lesion, Brainstem stroke, Brainstem tumor, Brainstem tumors, Glioma, Brainstem vascular malformations (AVM), Cerebral vascular accident (CVA), Cluster headache, Demyelinating disease, Demyelination brainstem, Hematomyelia, High cervical cord lesion, Hypothalamic lesion, Hypothalamic Stroke, Hypothalamic tumor, Intrapontine hemorrhage, Lesions in the hypothalamus or medulla, Multiple sclerosis, Myelitis , PICA syndrome, Posterior inferior cerebellar artery syndrome, Spinal cord demyelination, spinal cord Infarction , Spinal Meningioma, Syringomyelia, Wallenberg syndrome, Lateral medullary syndrome]
Nutritional/Metabolic	No underlying causes
Obstetric/Gynecologic	Birth trauma related, Birth trauma with injury to lower brachial plexus, Klumpke paralysis
Oncologic	Bronchogenic carcinoma, Carotid body tumor, Cavernous sinus Tumors, Cervical spinal cord tumor, Hodgkin disease, Internal carotid artery Tumor, Intramedullary Tumor, large cell Lung cancer, Mediastinal mass, Mediastinal Neuroblastoma, Mesothelioma, Metastasis, Nasopharyngeal carcinoma, Neuroblastoma, Pancoast syndrome, Parotid gland tumor, Pulmonary lymphoma, Rhabdomyosarcoma, Skull base lymphoma, Squamous cell Lung cancer, Superior cervical ganglion Jugular venous ectasia, Thoracic spinal cord tumor, Thyroid carcinoma
Ophthalmologic	No underlying causes
Overdose/Toxicity	No underlying causes
Psychiatric	No underlying causes
Pulmonary	Adeno carcinoma lung, Apical lung tumor
Renal/Electrolyte	No underlying causes
Rheumatology/Immunology/Allergy	No underlying causes
Sexual	No underlying causes
Trauma	Basal skull tumor, Cervical spinal cord injury, Cervico-thoracic Spinal cord Trauma, Internal carotid artery Trauma, Neck trauma, Superior cervical ganglion Trauma, Trauma - base of neck, Traumatic dislocation of cervical vertebrae
Urologic	No underlying causes
Miscellaneous	Cervical rib, Idiopathic, Superior cervical ganglion surgical dissection, Superior vena cava syndrome

Causes in Alphabetical Order

Acute otitis media Adenocarcinoma lung Aneurysm or dissection of the aorta Aortic aneurysm, thoracic Apical lung tumor Arnold-Chiari malformation Arteriovenous malformation Basal meningitis Basal skull tumors Birth trauma related Birth trauma with injury to lower brachial plexus Brain stem Demyelination Brain stem lesion Brainstem stroke Brainstem stroke Brainstem tumor Brain stem tumors glioma Brainstem vascular malformations (AVM) Bronchogenic cancer Bronchogenic carcinoma Carotid aneurysm Carotid angiography Carotid artery dissection Carotid artery thrombosis Carotid body tumor Carotid cavernous fistula Cavernous sinus Inflammation Cavernous sinus thrombosis Cavernous sinus Tumors Central venous catheterization Cerebral vascular accident Cervical plexus block Cervical rib Cervical spinal cord injury Cervical spinal cord tumor Cervico-thoracic Spinal cord Trauma Chest tube placement Cluster headache Congenital infections Coronary artery bypass grafting

Demyelinating disease Demyelination brainstem Dissecting aortic aneurysm Goitre Hematomyelia Herpes zoster High cervical cord lesion Hodgkin disease Hydatid cyst Hypothalamic lesion Hypothalamic Stroke Hypothalamic tumor Idiopathic Internal carotid artery Aneurysm Internal carotid artery Arteritis Internal carotid artery Dissection Internal carotid artery Thrombosis Internal carotid artery Trauma Internal carotid artery Tumor Interscalene block Intramedullary Tumor Intrapontine hemorrhage Invasive pituitary tumor Jugular cannulation Klumpke paralysis Large cell Lung cancer Lesions in the hypothalamus or medulla Lesions of the middle ear Lesions of the subclavian or common carotid artery Leukemia Lymphadenopathy Lymphoma Mandibular tooth abscess Mediastinal mass Mediastinal Neuroblastoma Mesothelioma Metastasis Middle ear infection Multiple sclerosis Myelitis

Nasopharyngeal carcinoma Neck surgery Neck trauma Neuroblastoma Neurofibromatosis type 1 Pancoast syndrome Parotid gland tumor PICA syndrome Pituitary tumor Posterior inferior cerebellar artery syndrome Pulmonary lymphoma Radical neck dissection Rhabdomyosarcoma Skull base lymphoma Spinal cord demyelination spinal cord Infarction Spinal Meningioma Squamous cell Lung cancer Stellate ganglion block Subclavian artery aneurysm Superior cervical ganglion Jugular venous ectasia Superior cervical ganglion surgical dissection Superior cervical ganglion Trauma Superior vena cava syndrome Sympathectomy Syringomyelia Thoracic Aortic aneurysm Thoracic spinal cord tumor Thoracic surgery Thyroid carcinoma Thyroidectomy Trauma - base of neck Traumatic dislocation of cervical vertebrae Traumatic dissection of the vertebral artery Tuberculosis Tuberculosis adenitis Wallenberg syndrome (lateral medullary syndrome)

References