Painful isolated Horner's syndrome caused by pontine ischaemia.
OBJECTIVE
To alert ophthalmologists to the possibility of brainstem ischaemia in patients with isolated Horner's syndrome.


METHODS
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.


CONCLUSIONS
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.
Crevits
Luc
L
Department of Neurology, Ghent University Hospital, De Pintelaan 185, 9000 , Ghent, Belgium. luc.crevits@ugent.be.
D'Herde
Katharina
K
Department of Anatomy and Embryology, Ghent University, Ghent, Belgium.
Deblaere
Karel
K
Department of Radiology, Ghent University Hospital, Ghent, Belgium.
D002545:Brain Ischemia / Q000150:complications* / Q000175:diagnosis; D001933:Brain Stem / Q000473:pathology*; D005260:Female; D006261:Headache / Q000150:complications; D006732:Horner Syndrome / Q000209:etiology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged