Angiographic Findings in the Tolosa-Hunt Syndrome: Painful Ophthalmoplegia

Sondheimer, Fred K.; Knapp, J. H.

doi:10.1148/106.1.105

Cited by 58 publications

(27 citation statements)

References 14 publications

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“…Evidence supporting the value of orbital phlebography in similar cases was reported in the following years (1,4,5,7,9,12,14,18,22,23). In 1979 MUHLETALER & GERLOCK (16) reported 26 cases with a clinical diagnosis of TolosaHunt's syndrome.…”

supporting

confidence: 54%

Orbital Phlebography in Patients with Tolosa-Hunt's Syndrome in Comparison with Normal Subjects

Hannerz¹,

Ericson²,

Bergstrand³

1984

Acta Radiologica. Diagnosis

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Orbital phlebography has been reported to be pathologic in some patients with Tolosa-Hunt's syndrome (recurrent painful ophthalmoplegia). A systematic study of the phlebographic findings in Tolosa-Hunt's syndrome in comparison with a normal material seems not to have been performed. In this investigation, orbital phlebography was performed in 19 patients with Tolosa-Hunt's syndrome and in a reference group of 23 persons without the disease. In 13 of 19 patients (68%) with Tolosa-Hunt's syndrome, the phlebography was pathologic (narrowing or occlusion of particularly the third segment of the superior ophthalmic vein, partial occlusion of the cavernous sinus). Orbital phlebography was normal in all but one of the subjects in the reference group. The medical history of this subject in retrospect revealed symptoms other than painful ophthalmoplegia commonly found in patients with Tolosa-Hunt' syndrome, suggesting that he suffered from a variant of the disease causing the syndrome. In one patient with recurrent painful ophthalmoplegia a biopsy from an eye muscle showed venous vasculitis, probably indicating the basic pathology behind the phlebographic changes in patients with Tolosa-Hunt's syndrome.

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supporting

confidence: 54%

Orbital Phlebography in Patients with Tolosa-Hunt's Syndrome in Comparison with Normal Subjects

Hannerz¹,

Ericson²,

Bergstrand³

1984

Acta Radiologica. Diagnosis

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“…[3][4][5][6][7]. However, a normal orbital venogram or artenogram does not exclude THS, and one series found no vascular abnormality in 1 6 of 26 cases [7].…”

Section: Thsmentioning

confidence: 99%

MR imaging of Tolosa-Hunt syndrome.

Yousem

Atlas

Grossman

et al. 1990

American Journal of Roentgenology

102

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“…The case reported by Tolosa showed narrowing of the carotid siphon just distal to the cavernous sinus [24]. Orbital phlebographies revealed abnormalities in a majority of patients: complete ipsilateral occlusion of the superior ophthalmic vein and at least partial obliteration of the cavernous sinus [8,16,21].…”

Section: Introductionmentioning

confidence: 97%

The criteria of the International Headache Society for Tolosa-Hunt syndrome need to be revised

Förderreuther¹,

Straube²

1999

Journal of Neurology

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In 1988 the International Headache Society defined the diagnostic criteria of Tolosa-Hunt syndrome (THS) to include episode(s) of unilateral orbital pain for an average of 8 weeks if untreated, with associated paresis of one or more of the third, fourth, and sixth cranial nerves. Cranial nerve paresis may coincide with the onset of pain or follow it within a period of up to 2 weeks, and the pain must be relieved within 72 h after the initiation of corticosteroid therapy. Other causative lesions must be excluded by neuroimaging. On the basis of the history and neuroradiological findings of six patients we show the pitfalls in diagnosing THS with these criteria. We propose a revision of the criteria: Other causative lesions must be excluded by neuroimaging, especially of the region of the cavernous sinus and the orbita, and by blood and CSF examinations. Since imaging techniques have dramatically improved, it is now possible to visualize the inflammatory tissue in THS. Positive magnetic resonance imaging or computed tomography findings compatible with inflammatory tissue neither exclude nor confirm THS and remain suspect until a malignant tumor or inflammation other than THS is excluded. Clinical and radiological follow-up examinations must be performed for at least 2 years, even in patients with negative findings on magnetic resonance imaging at onset.

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Angiographic Findings in the Tolosa-Hunt Syndrome: Painful Ophthalmoplegia

Cited by 58 publications

References 14 publications

Orbital Phlebography in Patients with Tolosa-Hunt's Syndrome in Comparison with Normal Subjects

Orbital Phlebography in Patients with Tolosa-Hunt's Syndrome in Comparison with Normal Subjects

MR imaging of Tolosa-Hunt syndrome.

The criteria of the International Headache Society for Tolosa-Hunt syndrome need to be revised

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