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Case Reports
. 2017 Jan-Mar;12(1):106-109.
doi: 10.4103/2008-322X.200171.

Tolosa-Hunt Syndrome Demonstrated by Constructive Interference Steady State Magnetic Resonance Imaging

Nisar A Wani  1 , Majid Jehangir  1 , Parveen A Lone  2
Affiliations
Case Reports

Tolosa-Hunt Syndrome Demonstrated by Constructive Interference Steady State Magnetic Resonance Imaging

Nisar A Wani et al. J Ophthalmic Vis Res. 2017 Jan-Mar.

Abstract

Purpose: To highlight the role of constructive interference steady state (CISS) magnetic resonance imaging (MRI) in the diagnosis of Tolosa-Hunt Syndrome (THS).

Case report: We describe a case of THS in a 55-year-old woman presenting with left painful opthalmoplegia that was diagnosed by CISS MRI. Patient responded to steroid treatment and the lesion resolved.

Conclusion: Imaging with MRI can help in making the diagnosis of THS by demonstrating an enhancing soft tissue lesion in the cavernous sinus and orbital apex resolving with steroids. CISS MRI is a sensitive sequence for diagnosis and follow-up imaging in THS.

Keywords: Cavernous Sinus; Constructive Interference Steady State Magnetic Resonance Imaging; Painful Ophthalmoplegia; Tolosa-Hunt Syndrome.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Coronal T2-weighted magnetic resonance image (T2W MRI) shows subtle hypointense signal intensity lesion in the left cavernous sinus lateral to internal carotid artery.
Figure 2
Figure 2
Axial constructive interference steady state (CISS) magnetic resonance image (MRI) showing enlarged left cavernous sinus due to a hypointense signal intensity lesion lateral to internal carotid artery (arrow), lesion is extending anteriorly towards the orbital apex.
Figure 3
Figure 3
Post-gadolinium enhanced T1-weighted magnetic resonance image (T1W MRI) shows intensely enhancing lesion in the left cavernous sinus (arrow) lateral to medially displaced internal carotid artery. Lesion appears larger as compared to T2-weighted (T2W) coronal image [Figure 1].
Figure 4
Figure 4
Post-contrast T1-weighted (T1W) axial magnetic resonance image (MRI) showing homogenous enhancement of the left cavernous sinus lesion (arrow); lesion is seen extending up to orbital apex as shown by constructive interference steady state MRI.
See this image and copyright information in PMC

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