title: Neuroimaging experience in pediatric Horner syndrome.
abstract: BACKGROUND
  Horner syndrome in children is rare. The frequency and spectrum of malignancy as the cause of Horner syndrome in children remains unclear. Also unclear is whether the imaging work-up should include the entire oculo-sympathetic pathway or should be more targeted. In addition, the value of cross-sectional angiographic imaging in Horner syndrome is uncertain.
  
  
  OBJECTIVE
  To review imaging pathology in a cohort of children with Horner syndrome at a major academic pediatric medical center.
  
  
  METHODS
  We reviewed a 22-year period of CT and MR imaging studies in children with a clinical diagnosis of Horner syndrome referred for imaging.
  
  
  RESULTS
  We found 38 patients who fulfilled study criteria of Horner syndrome and 6/38 had relevant imaging findings: 2/6 etiologies were neoplastic (congenital neuroblastoma and central astrocytoma), 1/6 had a vascular abnormality (hypoplastic carotid artery), 1/6 had maldevelopment (Chiari I malformation), and 2/6 had inflammatory/traumatic etiology (viral cervical lymphadenopathy, post jugular vein cannulation). There was a similar number of congenital and acquired pathologies. The malignancies were found at any level of the oculosympathetic pathway.
  
  
  CONCLUSIONS
  There are treatable causes, including malignancies, in children presenting with Horner syndrome, which justify imaging work-up of the entire oculosympathetic pathway, unless the lesion level can be determined clinically.
authors.affiliation: Department of Radiology, Boston University Medical Center, Boston University School of Medicine, 820 Harrison Ave., FGH Building, 3rd Floor, Boston, MA, 02118, USA, nkpiano@gmail.com.
authors.forename: Nadja
authors.initials: N
authors.lastname: Kadom
authors.forename: N Paul
authors.initials: NP
authors.lastname: Rosman
authors.forename: Shams
authors.initials: S
authors.lastname: Jubouri
authors.forename: Anna
authors.initials: A
authors.lastname: Trofimova
authors.forename: Alexia M
authors.initials: AM
authors.lastname: Egloff
authors.forename: Wadih M
authors.initials: WM
authors.lastname: Zein
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004219:District of Columbia; D005123:Eye / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D006732:Horner Syndrome / Q000000981:diagnostic imaging* / Q000473:pathology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D059906:Neuroimaging; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D055815:Young Adult
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