Tolosa Hunt syndrome

Case contributed by G Balachandran
Diagnosis almost certain

Presentation

A young pregnant woman presented with acute onset of pain in the left orbit with multiple cranial palsies involving III, IV, V, VI cranial nerves.

Patient Data

Age: Child-bearing age
Gender: Female

Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.

mri

MRI was done with and without contrast agent. There was a 9 x 4 mm isointense lesion inside the left cavernous sinus, partially encasing the left internal carotid artery. The cavernous sinus on the left side was enlarged and the lesion showed mild contrast enhancement.

Case Discussion

MR angiography was also done to rule out aneurysm. Thus the clinical diagnosis of Tolosa Hunt syndrome was confirmed. After steroid treatment, the patient showed dramatic improvement.

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