Ayse Betul ACAR, Hale Zeynep Batur CAGLAYAN, Ayse Ilksen COLPAK, Murat UCAR, Taylan ALTIPARMAK, Bijen NAZLIEL
Turkish Journal of Neurology - 2026;32(1):11-18
Objectives: This study aimed to investigate the etiology in patients with Horner syndrome (HS) using neuroimaging studies based on demographic and clinical characteristics and to contribute to clinical practice by developing a practical algorithm based on our findings and integrating current neuroimaging techniques. Patients and methods: This retrospective, two-center study evaluated 54 patients (28 males, 26 females; mean age: 49.3 +/- 14.1 years; range, 21 to 76 years) with HS between January 2013 and February 2022. Demographic and clinical features of the patients, the response to apraclonidine, and neuroimaging study findings were evaluated. Results: Of the cases included in the study, 18 (33.3%) were idiopathic, three (5.5%) were congenital, 13 (24.1%) were central (first-order neuron), 11 (20.4%) were preganglionic (second-order neuron), and nine (16.7%) were postganglionic (third-order neuron). Localized etiology was affirmed in 33 (61.8%) of 54 patients. Conclusion: This study showed that neuroimaging methods easily identified etiology in patients with additional neurological findings in HS. The underlying causes could not be defined in a significant part of patients with isolated HS. However, it is essential to carry out detailed neuroimaging studies according to clinical findings to exclude life-threatening causes in patients with HS.
