[Tolosa-Hunt syndrome. Report of a surgical case].

Neurologia Medico-chirurgica
T MatsumotoY Ushio

Abstract

A 58-year-old male presented with painful right ophthalmoplegia and was diagnosed as having Tolosa-Hunt syndrome. High-dose oral administration of a corticosteroid provided significant pain relief, but total ophthalmoplegia persisted. Computed tomography (CT) showed a tumor-like mass in the bilateral cavernous sinus. Angiography revealed occlusion of the right internal carotid artery. According to the literature, about 70% of cases of Tolosa-Hunt syndrome are caused by parasellar neoplasms. A transcranial biopsy of the patient's lesion revealed a nonspecific granulomatous process in the wall of the right cavernous sinus. He was again placed on high-dose corticosteroid therapy and within 1 week the right visual acuity improved slightly. The corticosteroid dose was gradually tapered over 3 months. After 2 months of therapy, the external ocular movement had almost fully recovered, although the light reflex was absent and the CT findings did not change.

Citations

Jan 1, 1993·Thyroid : Official Journal of the American Thyroid Association·A VailatiE Ascari
Jun 17, 2006·Cephalalgia : an International Journal of Headache·L La MantiaUNKNOWN International Headache Society
Apr 10, 2012·World Neurosurgery·Toshiaki KoderaYuka Kuronuma
Jun 30, 2021·Acta neurologica Belgica·Takafumi WadaRyosuke Takahashi

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