MR imaging of Tolosa-Hunt syndrome.
The Tolosa-Hunt syndrome consists of painful ophthalmoplegia caused by cavernous sinus inflammation, which is responsive to steroid therapy. The MR features of 11 patients with the clinical diagnosis of Tolosa-Hunt syndrome were studied. Two patients had normal MR studies of the orbit and cavernous sinuses. In nine patients, abnormal signal and/or mass lesions were seen in the cavernous sinuses; in eight cases, the abnormality was hypointense relative to fat and isointense with muscle on short TR/TE images and isointense with fat on long TR/TE scans. Extension into the orbital apex was seen in eight cases. In six of nine cases the affected cavernous sinus was enlarged; in five of nine it had a convex outer margin. One patient had a thrombosed cavernous sinus and superior ophthalmic vein in addition to a cavernous sinus soft-tissue mass. The signal intensity of Tolosa-Hunt syndrome in this limited series was similar to that of orbital pseudotumor and is confined to a limited differential diagnosis, which includes meningioma, lymphoma, and sarcoidosis.
Yousem
D M
DM
Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia 19104.
Atlas
S W
SW
Grossman
R I
RI
Sergott
R C
RC
Savino
P J
PJ
Bosley
T M
TM
D000293:Adolescent; D000328:Adult; D000368:Aged; D002341:Carotid Artery Thrombosis / Q000175:diagnosis; D002426:Cavernous Sinus; D002648:Child; D005123:Eye / Q000098:blood supply; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009886:Ophthalmoplegia / Q000175:diagnosis*