scholarly journals Tolosa-Hunt Syndrome Presenting as Cluster-Like Headache

2021 ◽  
Vol 39 (4) ◽  
pp. 343-346
Author(s):  
Ja Hyeon Cho ◽  
Seon Jeong Kim ◽  
Dae-Hyun Kim
Keyword(s):  
Contrast Material ◽  
Inflammatory Lesion ◽  
Oculomotor Nerve ◽  
Oculomotor Nerve Palsy ◽  
Wall Thickening ◽  
Resonance Imaging ◽  
Lateral Aspect ◽  
Hunt Syndrome ◽  
Patient Reported ◽  
Headache Onset

A 48-year-old man came with a left-sided headache that was compatible with diagnostic criteria of cluster headache. Left oculomotor nerve palsy developed 2 weeks after headache onset. Magnetic resonance imaging showed wall thickening and enhancement by contrast material in the lateral aspect of the left cavernous sinus, consistent with a possible inflammatory lesion. The patient reported the almost complete remission of the pain and diplopia after steroid therapy. We speculate that Tolosa-Hunt syndrome should be included as a cause of cluster-like headaches.

scholarly journals A Case of Tolosa-Hunt Syndrome With Discoid Lupus Erythematosus

2019 ◽  
Vol 10 (1) ◽  
pp. 48-50
Author(s):  
Amy W. Yu ◽  
Eli J. Finkelsztein ◽  
Natalie T. Cheng
Keyword(s):  
Lupus Erythematosus ◽  
Severe Headache ◽  
Oculomotor Nerve ◽  
Oculomotor Nerve Palsy ◽  
Discoid Lupus Erythematosus ◽  
Resonance Imaging ◽  
Hunt Syndrome ◽  
Blurry Vision ◽  
Unusual Occurrence ◽  
Cutaneous Lupus

The occurrence of Tolosa-Hunt syndrome (THS) in the setting of discoid lupus erythematosus (DLE) has not been previously reported. We report a case of a 55-year-old Chinese man with established cutaneous lupus who presented with 1 week of worsening blurry vision and ptosis of the left eye with severe headache 2 weeks prior to presentation. His cranial nerve examination was significant for left afferent pupillary defect, red desaturation, ptosis, and oculomotor nerve palsy. He also presented with active DLE lesions. Magnetic resonance imaging brain demonstrated asymmetric thickening and enhancement of the left cavernous sinus consistent with THS. After a 4-week gradual steroid taper his ophthalmoplegia resolved. The unusual occurrence of THS and DLE prompts consideration of nonsystemic autoimmune disorders in diagnosis of THS.

scholarly journals Surgical Treatment of Cavernous Sinus Cavernomas: Evidence from Vietnam

Reports ◽  
2020 ◽  
Vol 3 (2) ◽  
pp. 16
Author(s):  
Duc-Anh Nguyen ◽  
Hao The Nguyen ◽  
Thang Van Duong ◽  
Binh Hoa Pham ◽  
Hoang-Long Vo
Keyword(s):  
Magnetic Resonance Imaging ◽  
Surgical Treatment ◽  
Magnetic Resonance ◽  
Cavernous Sinus ◽  
Nerve Palsy ◽  
Oculomotor Nerve ◽  
Oculomotor Nerve Palsy ◽  
Tumor Surgery ◽  
Resonance Imaging ◽  
Radical Removal

Cavernous sinus cavernomas, a rare vascular malformation, represents 3% of all benign cavernous sinus tumors. Both clinical and radiological signs are important for differentiating this condition from other cavernous sinus diseases. The best treatment is radical removal tumor surgery; however, due to the tumor being located in the cavernous sinus, there are many difficulties in the surgery. We report a case of a 35-year-old female who only presented sporadical headache. After serial magnetic resonance imaging acquisitions, a tumor measuring 30 mm in the left cavernous sinus and heterogenous enhencement was observed. Then, the patient underwent an operation with an extradural basal temporal approach. Postoperatively, the tumor was safely gross total removed. The patient developed left oculomotor nerve palsy but fully recovered after 3 months of acupunture treatment, and developed persistent left maxillofacial paresthesia. The surgical treatment for cavernous sinus cavernomas may be considered a best choice regarding safety and efficiency.

scholarly journals Bilateral Intracavernous Carotid Artery Aneurysms Presenting as Diplopia in a Young Patient

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Nikolaos Kopsachilis ◽  
Maria Pefkianaki ◽  
Gianluca Carifi ◽  
Ioannis Lialias
Keyword(s):  
Carotid Artery ◽  
Young Patients ◽  
Oculomotor Nerve ◽  
Oculomotor Nerve Palsy ◽  
Resonance Imaging ◽  
Intracavernous Carotid Artery ◽  
Life Threatening ◽  
Endovascular Coil Embolization ◽  
The Brain ◽  
Underlying Pathology

Introduction. Bilateral intracavernous carotid artery aneurysms (ICAAs) are extremely rare and difficult to treat.Case Report. A 26-year-old female presented in our clinic with acute diplopia due to oculomotor nerve palsy on the left side. Magnetic resonance imaging of the brain showed two heterogeneously enhanced masses indicating bilateral ICAA. An endovascular coil embolization was performed on the left side successfully, resulting in resolution of her symptoms.Conclusion. Thorough systemic evaluation in young patients with diplopia can reveal life-threatening underlying pathology and prevent major complications.

scholarly journals High-resolution magnetic resonance imaging in isolated, traumatic oculomotor nerve palsy: A case report

2021 ◽  
Vol 16 (2) ◽  
pp. 384-388
Author(s):  
Felix Eisenhut ◽  
Stefan T. Gerner ◽  
Philipp Goelitz ◽  
Arnd Doerfler ◽  
Frank Seifert
Keyword(s):  
Magnetic Resonance Imaging ◽  
Case Report ◽  
Magnetic Resonance ◽  
High Resolution ◽  
Nerve Palsy ◽  
Oculomotor Nerve ◽  
Oculomotor Nerve Palsy ◽  
Resonance Imaging

scholarly journals Tolosa-Hunt Syndrome: A Case Report

2021 ◽  
Vol 59 (238) ◽  
Author(s):  
Siddhanta K.C. ◽  
Shreeyanta K.C. ◽  
Prajjwal Kunwar ◽  
Krishna Dhungana
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Steroid Therapy ◽  
Nerve Palsy ◽  
Rectus Muscle ◽  
Abducens Nerve ◽  
Oculomotor Nerve Palsy ◽  
Unknown Etiology ◽  
Resonance Imaging ◽  
Hunt Syndrome

Tolosa-Hunt Syndrome is a rare disease characterized by painful ophthalmoplegia affecting third, fourth, and/or sixth cranial nerve caused by non-specific inflammation in the cavernous sinus or superior orbital fissure of unknown etiology. We presented a 67-year-old female with Tolosa-Hunt Syndrome. She had a right-sided headache and periorbital pain with double vision. Examination showed right-sided ptosis, right-sided trochlear and abducens nerve palsy, and partial right-sided oculomotor nerve palsy with hypoesthesia in the area of the ophthalmic division of the trigeminal nerve. Magnetic resonance imaging of head and orbit showed altered signal intensity changes in the optic nerve and lateral rectus muscle. After steroid therapy, pain and ptosis were significantly improved in 72 hours. Tolosa-Hunt Syndrome is a diagnosis of exclusion, with clinical presentation, normal investigations, magnetic resonance imaging findings, and response to steroid therapy crucial in making the diagnosis.

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