• Joaquim C Teixeira, Maria M Santos, and João L Melancia.
• Department of Neurosurgery, Hospital de Santa Maria (CHLN), Lisbon, Portugal. Electronic address: joaquimcruzteixeira@hotmail.com.
• World Neurosurg. 2017 Nov 1; 107: 1050.e13-1050.e15.

BackgroundThe incidence of thoracic disk herniation is estimated to be 1000 to 1,000,000. Upper thoracic disk herniation is an exceedingly rare pathology with unique neurologic features. We report a case of a young patient who presented with Horner syndrome caused by a T1-T2 disk herniation.Case DescriptionA 34-year-old female patient was admitted to the emergency department presenting a sudden-onset history of ptosis and miosis on the left eye (Horner syndrome). She reported a 2-month history of neck, scapular, and medial left arm and forearm pain and numbness. The cervical magnetic resonance image showed a T1-T2 left disk herniation with intraforaminal compression of the T1 nerve root. A microdiskectomy was performed, and both left arm pain and Horner syndrome have completely regressed.ConclusionsSymptomatic T1-T2 disk herniation is an uncommon condition in a spine surgeon daily routine. The differential diagnosis for patients presenting upper limb pain and Horner's Syndrome should include upper thoracic disk herniation. Patients' outcomes can be excellent if an adequate surgical treatment is timely provided.Copyright © 2017 Elsevier Inc. All rights reserved.

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