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[Tolosa-Hunt syndrome--case report].

C L Wong1, W T Chiu, J H Wang

  • 1Department of Ophthalmology, Taipei Medical College Hospital.

Zhonghua Yi Xue Za Zhi = Chinese Medical Journal; Free China Ed
|July 1, 1991
PubMed
Summary

A head injury led to painful ophthalmoplegia, initially treated as Tolosa-Hunt syndrome with steroids. Surgical removal of parasellar granulation tissue resolved symptoms, revealing inflammation, not malignancy.

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Area of Science:

  • Neurology
  • Ophthalmology
  • Pathology

Background:

  • Tolosa-Hunt syndrome is characterized by painful ophthalmoplegia, often treated with corticosteroids.
  • Parasellar lesions can cause significant neurological and ophthalmological symptoms.

Observation:

  • A 38-year-old male presented with painful ophthalmoplegia two years post-head injury.
  • Initial diagnosis was Tolosa-Hunt syndrome, managed with long-term, unsustained oral steroid therapy.
  • Computed tomography revealed persistent growth of a parasellar lesion despite treatment.

Findings:

  • Craniotomy and partial extirpation of the parasellar lesion were performed due to symptom aggravation.
  • Pathological examination confirmed granulation tissue with acute and chronic inflammation.
  • No evidence of malignancy was detected.

Implications:

  • Surgical intervention may be effective for refractory parasellar lesions causing painful ophthalmoplegia.
  • Histopathological confirmation is crucial to differentiate inflammatory lesions from other pathologies.
  • This case highlights the importance of considering surgical options when medical management fails for parasellar masses.

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