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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 27:1318-1320, June-July 2006
© 2006 American Society of Neuroradiology

Case Report
HEAD AND NECK

A Case of Horner Syndrome with Intermittent Mydriasis in a Patient with Hypoplasia of the Internal Carotid Artery

M. Ibrahim, H.M. Branson, J.R. Buncic and M.M. Shroff

From the Departments of Radiology, Hospital for Sick Children, Toronto, Ontario, Canada
Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada
Ophthalmology, Hospital for Sick Children, Toronto, Ontario, Canada

Address correspondence to Helen Branson, MD, c/o Jennifer J. Russell, Department of Diagnostic Imaging, The Hospital for Sick Children, 555 University Ave, Toronto, Ontario, M5G 1X8, Canada

SUMMARY: We report a rare case of hypoplasia of the right internal carotid artery (ICA) with ipsilateral congenital Horner syndrome. The etiology and pathogenesis of hypoplasia of the ICA is not well understood. Multiple types of collateral flow have been reported to develop to maintain blood supply to the ipsilateral cerebral hemisphere. Although collateral flow may allow these patients to remain asymptomatic, we postulate that the enlarged posterior communicating artery (PcomA) in our patient caused mass effect on the cisternal segment of cranial nerve III causing intermittent mydriasis apart from Horner syndrome.