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Back to Top Causes. Horner syndrome can be caused by any interruption in a set of nerve fibers that start in the part of the brain called the hypothalamus and travel to the face and eyes. Sympathetic nerve fiber injuries can result from: 1  Injury to one of the main arteries to the brain (carotid artery).
There are a number of potential causes of Hornerâs syndrome, each affecting a different place in the sympathetic chain: 1  First order neuron lesion: brainstem stroke. 2  Second order neuron lesion: apical lung tumor, neck trauma, other. 3  Third order neuron lesion: orbital trauma or inflammation, carotid dissection, other.