[Tolosa-Hunt syndrome. Report of a surgical case].
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.
Matsumoto
T
T
Kitano
I
I
Tanaka
Y
Y
Kuratsu
J
J
Ushio
Y
Y
D000792:Angiography; D001623:Betamethasone / Q000627:therapeutic use*; D002426:Cavernous Sinus / Q000473:pathology; D006099:Granuloma / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009886:Ophthalmoplegia / Q000175:diagnosis / Q000188:drug therapy* / Q000601:surgery; D014057:Tomography, X-Ray Computed
D001623:Betamethasone