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Congress: ECR25
Poster Number: C-21566
Type: Poster: EPOS Radiologist (educational)
Authorblock: I. A. Danciu, E. A. Marciuc, A. Gherman, C. Tudorache, B. I. Dobrovat, D. Haba; Iasi/RO
Disclosures:
Irina Amalia Danciu: Nothing to disclose
Emilia Adriana Marciuc: Nothing to disclose
Alexandra Gherman: Nothing to disclose
Cornelia Tudorache: Nothing to disclose
Bogdan Ionut Dobrovat: Nothing to disclose
Danisia Haba: Nothing to disclose
Keywords: CNS, Neuroradiology brain, Vascular, CT-Angiography, MR, MR-Angiography, Diagnostic procedure, Aneurysms, Cancer, Ischaemia / Infarction
Learning objectives Horner’s Syndrome (HS) is a neurological condition caused by disruption of the sympathetic pathway, leading to ptosis, miosis, and anhidrosis. Given its varied etiologies, accurate radiological evaluation is crucial for diagnosis and management.Study Objectives: Establish a systematic, location-based imaging approach for HS, categorizing lesions as central, preganglionic, or postganglionic. Optimize imaging protocols with a focus on MRI, CT, and vascular imaging. Foster interdisciplinary collaboration to enhance diagnosis and treatment. Utilize case-based illustrations to improve understanding of sympathetic pathway disruptions. By mapping lesion locations with multimodal...
Read more Background A retrospective analysis was conducted at the Emergency Clinical Hospital "Prof. Dr. N. Oblu," Iasi, reviewing 44 HS cases over a 10-year period (2014–2024).Imaging Modalities & Protocols MRI: Primary modality for central (first-order neuron) lesions, providing high-resolution imaging of the brainstem, hypothalamus, and spinal cord. CT & CTA: Used for preganglionic/postganglionic lesions, particularly vascular abnormalities (carotid dissections, aneurysms) and bony pathologies (cervical fractures, Pancoast tumors). MRA: Applied in suspected vascular etiologies, complementing CT for carotid dissections and intracranial vessel pathologies.
Read more Findings and procedure details Each case was classified based on: Clinical Presentation: Ptosis, miosis, and anhidrosis. [fig 2] Lesion Localization: Central (hypothalamus/brainstem), Preganglionic (cervical/thoracic), or Postganglionic (carotid plexus to orbit). [fig 1] Etiology Categorization:  [fig 3] Imaging Efficacy: Evaluated through diagnostic yield, lesion localization accuracy, and impact on patient management. Lesion Distribution & Imaging CorrelationCentral Lesions (First-Order Neuron) [fig 4] Common causes: Brainstem infarcts (e.g., lateral medullary syndrome), demyelination, neoplasms. [fig 5] Examples: Ischemic Stroke: A 56-year-old male with cardiovascular risk factors presented with left Horner’s syndrome, vertigo, and occipital headache. Initial CT was negative; MRI confirmed a left medullary infarct, consistent...
Read more Conclusion This study highlights the importance of systematic imaging in localizing Horner’s Syndrome lesions.Key Takeaways: Precise Lesion Localization Enhances Diagnosis: Categorizing lesions into central, preganglionic, and postganglionic types significantly improves radiological accuracy. Tailored Imaging Protocols Optimize Efficiency: MRI is preferred for central lesions. CT/CTA is crucial for preganglionic/postganglionic vascular assessments. MRA complements CTA in carotid dissections. Interdisciplinary Collaboration is Essential: Close cooperation between radiologists, neurologists, and neurosurgeons ensures timely diagnosis and reduces morbidity.Graphic Schematic Representations Enhance Training: Simplifies understanding of sympathetic pathway disruptions.A Structured Approach Reduces Diagnostic Delays & Unnecessary Imaging.Further refinement of...
Read more References https://radiologyassistant.nl/neuroradiology/horners-syndromehttps://radiopaedia.org/articles/horner-syndrome
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