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Quantitative Analysis and Characterization of Atherosclerotic Lesions in the Murine Aortic Sinus
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A cavernous sinus lesion clinically responsive to steroids.

M W Ruff1, I D Carabenciov1, D R Johnson1

  • 1Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, USA.

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
|April 25, 2018
PubMed
Summary
This summary is machine-generated.

Tolosa-Hunt syndrome (THS) presents as painful ophthalmoplegia. A rare skull base tumor, chordoma, can mimic THS, highlighting the need for vigilant follow-up and biopsy in non-responsive cases.

Keywords:
ChordomaNeuro-oncologyTolosa-Hunt syndrome

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Area of Science:

  • Neuro-ophthalmology
  • Neuropathology
  • Radiology

Background:

  • Tolosa-Hunt syndrome (THS) involves painful ophthalmoplegia due to cavernous sinus inflammation.
  • MRI shows enhancing lesions in the cavernous sinus, potentially narrowing the internal carotid artery.
  • THS is a diagnostic consideration for multiple cranial neuropathies, but differentials are broad.

Observation:

  • A patient presented with symptoms mimicking THS, showing a persistent unilateral cavernous sinus MRI abnormality.
  • The patient showed clinical improvement with steroids but no radiographic response.
  • Reevaluation and pathology revealed the lesion was a chordoma, a rare skull base tumor.

Findings:

  • Chordoma can present as a cavernous sinus lesion, mimicking Tolosa-Hunt syndrome.
  • Steroid treatment may yield partial clinical improvement in some non-inflammatory lesions.
  • Radiographic stability or progression despite treatment suggests alternative diagnoses.

Implications:

  • Close clinical and radiographic monitoring is crucial for presumed THS cases.
  • Consider biopsy early in patients with THS who lack clinical and radiographic response to steroids.
  • Accurate diagnosis of cavernous sinus lesions is vital for appropriate management and prognosis.