Selective MR imaging approach for evaluation of patients with Horner's syndrome.

PURPOSE: To assess the usefulness of MR in the evaluation of patients with Horner's syndrome. PATIENTS AND METHODS: We prospectively performed MR imaging in 33 patients with Horner's syndrome (13 preganglionic and 20 postganglionic) using a protocol specifically designed for pre- and postganglionic varieties of this syndrome. Assignment of patients to pre- or postganglionic categories was performed on the basis of pharmacologic testing. RESULTS: Abnormalities in one-half of the patients with preganglionic Horner's syndrome included lateral medullary infarct, spinal cord/root disease, apical lung tumor, and paravertebral metastatic mass. Three of 20 patients with postganglionic Horner's syndrome had carotid artery dissection. CONCLUSION: Routine scanning of patients who have postganglionic Horner's syndrome with cluster headaches was not helpful in our small series.