Horner syndrome in ipsilateral lenticulostriate stroke: a novel localization for a classic stroke syndrome
Horner’s syndrome has important localizing and etiological value in acute ischemic stroke. In a prospective series of consecutive acute ischemic stroke patients, we identified three patients with Horner’s syndrome and contralateral hemiparesis due to ipsilateral small deep infarction in the middle cerebral artery territory (lenticulostriate arteries). Lacunar stroke was the most likely stroke mechanism in all three patients. This observation might suggest the existence of an uncrossed cortico-hypothalamic sympathetic pathway passing through the basal ganglia and modulating oculosympathetic function.
KeywordsAlternate syndrome Horner syndrome Lacunar stroke Acute ischemic stroke
We thank Dr Andrea Rossetti from the Centre Hospitalier Universitaire Vaudois for helpful discussion and suggestions for this manuscript. We thank Melanie Price Hirt for English language correction and editing.
Stefania Nannoni, study concept and design, acquisition of data Philippe Maeder, analysis and interpretation of radiological data François Vingerhoets, analysis and interpretation of clinical data Patrik Michel, study concept and design, analysis and interpretation of data, study supervision and critical revision of manuscript for intellectual content.
This project was supported by the European Academy of Neurology (EAN).
Compliance with ethical standards
Conflict of interest
Stefania Nannoni reports no disclosures. Philippe Maeder reports no disclosures. François Vingerhoets reports no disclosures. Prof. Patrik Michel has received funding within the last 3 years through his institution research grants from the Swiss Heart Foundation, Boehringer-Ingelheim, and BMS; speaker fees from Boehringer-Ingelheim, Bayer, Daiichi-Sankyo, Medtronic, and Amgen; honoraria from scientific advisory boards from Boehringer-Ingelheim, Bayer, Pfizer and BMS; consulting fees from Medtronic, Astra-Zeneca, and Amgen. All this support is received by his institution (CHUV) and is used for stroke education and research.
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