Horner Syndrome and Thoracic Disc Herniation

A 45-year-old woman presented with acute Horner syndrome associated with several weeks of midscapular pain radiating to the left upper extremity. The physical examination showed a left-sided Horner syndrome (Figure 1A) and signs of an ipsilateral radiculopathy of the first thoracic root with numbness and weakness in the T1 distribution. By computed tomography angiography, a dissection of the internal carotid artery was excluded. Spinal magnetic resonance imaging (MRI) demonstrated a pronounced disc herniation at the T1-2 level (Figure 1B and andC).C). A laminoforaminotomy via a posterior approach was performed resulting in complete recovery