Tolosa Hunt syndrome
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.
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Isointense left cavernous sinus mass partially encasing internal carotid artery.
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. 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.