gms | German Medical Science

56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)
3èmes journées françaises de Neurochirurgie (SFNC)

Deutsche Gesellschaft für Neurochirurgie e. V.
Société Française de Neurochirurgie

07. bis 11.05.2005, Strasbourg

Tolosa-Hunt syndrome with involving structures outside the cavernous sinus: report a case with histological study

Tolosa-Hunt-Syndrom mit betreffenden Strukturen außerhalb das höhlenartige Stirnhöhle: berichten Sie einen Rechtsfall mit histologischem Studium

Meeting Abstract

  • corresponding author B. El Mostarchid - Neurosurgery Department of Mohammed V Military Teaching Hospital, Rabat, Morocco
  • A. Akhddar - Neurosurgery Department of Mohammed V Military Teaching Hospital, Rabat, Morocco
  • M. Gazzaz - Neurosurgery Department of Mohammed V Military Teaching Hospital, Rabat, Morocco
  • B. Kadiri - Neurosurgery Department of Mohammed V Military Teaching Hospital, Rabat, Morocco
  • M. Boucetta - Neurosurgery Department of Mohammed V Military Teaching Hospital, Rabat, Morocco

Deutsche Gesellschaft für Neurochirurgie. Société Française de Neurochirurgie. 56. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC), 3èmes journées françaises de Neurochirurgie (SFNC). Strasbourg, 07.-11.05.2005. Düsseldorf, Köln: German Medical Science; 2005. DocP039

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2005/05dgnc0307.shtml

Veröffentlicht: 4. Mai 2005

© 2005 El Mostarchid et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective

Tolosa-Hunt syndrome (THS) also known as painful ophtalmoplegia is a rare entity characterised by unilateral retro-orbital or hemicranial pain and variable numbness and paresis of the third, fourth, and or sixth cranial nerves. Having a relapsing and remitting course and response to systemic corticosteroid therapy. The THS is due to idiopathic non granulomatous inflammation process of CS. Results of neuroimaging studies obtained in STH may be unremarkable. The diagnosis is made by exclusion of others infiltrative processes such as meningioma, lymphoma, and infection processes that mimic THS. To report a case of THS with involving structures outside the CS with histological confirmation

Methods

A 37 year immuno-competent man presented with right unilateral painful ophtalmoplegia. Computer tomodensitometry scan (CT) and Magnetic resonance imaging (MRI) showed a lesion of right CS with extension in to upper clivus and posterior wall of CS. Exhaustive biological and radiological study showed no abnormalities and excluded others aetiologies mimicking THS. The involving outside of CS was uncommon.

Results

A surgical biopsy was made via transsphenoidal approach targeting the upper clivus and posterior wall extension of the SC. Histological study showed an idiopathic non granulomatous inflammation. The response to systemic corticosteroid therapy was unremarkable within 72 hours.The patient responded with resolution of his retro-orbital pain and gradual improvement in ptosis and ophtalmoplegia. Six month postoperative CT scan showed decreased size volume of CS. MRI showed decreased in signal and volume of CS With 18 months Follow-up the patient is asymptomatic with no clinical recurrence.

Conclusions

The aetiology of THS is an idiopathic non granulomatous inflammation process of CS. The diagnosis is therefore made by exclusion. Biopsy of the lesion may require confirming the diagnosis. Biopsy of the posterior wall of cavernous sinus via transsphenoidal approach is simple rapid and effective to confirm the non-specific inflammatory in THS and excluding others aetiologies mimicking THS.