ICHD-II Diagnostic Criteria for Tolosa—Hunt Syndrome in Idiopathic Inflammatory Syndromes of the Orbit and/or the Cavernous Sinus

Colnaghi, Silvia; Versino, Maurizio; Marchioni, Enrico; Pichiecchio, Anna; Bastianello, Stefano; Cosi, V.; Nappi, Giuseppe

doi:10.1111/j.1468-2982.2008.01569.x

Cited by 92 publications

(79 citation statements)

References 48 publications

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“…Study results confi rmed that defi nitive diagnosis of THS should be based on brain MRI, which was positive in 92.1% of THS patients because regression of symptoms was confi rmed in only 2% of patients within 72 hours after corticosteroid therapy application. Data analysis of the possible infl ammatory process localization included not only the cavernous sinus, but also the orbit (THS plus syndrome or pseudotumor) 3 . Furthermore, MRI analysis showed residual signs of infl ammation after the symptoms had subsided, thus suggesting that infl ammation might be present up to several months after regression of symptoms.…”

Section: Discussionmentioning

confidence: 99%

Tolosa-Hunt Syndrome – Case Report

Penić

Lisak

Gregurić

et al. 2017

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SUMMARY -Th is case report presents a patient diagnosed with Tolosa-Hunt syndrome (THS) after an extensive neuro-diagnostic and neuroimaging evaluation. Diagnostic work-up included thorough physical and neurological examination, complete laboratory serum assessments, neuroendocrine and immunohistochemistry analysis, cerebrospinal fl uid analysis, neurophysiology assessment, ophthalmologist examination and neuroimaging. Th e most important diagnostic tool in deriving the diagnosis of THS was neuroimaging evaluation that included baseline and follow-up cranial contrast enhanced magnetic resonance imaging (MRI). Baseline cranial contrast enhanced MRI detected a nonspecifi c infl ammatory granulomatous lesion in the right cavernous sinus extending basally towards the right trigeminal cave (Meckel's cave) and anteriorly towards the apex of the right orbit. Systemic intravenous high-dose corticosteroid therapy was administered for 3 consecutive days and then tapered down to lower oral steroid doses. Following therapy, the patient experienced complete regression of symptoms. Follow-up cranial contrast enhanced MRI showed signifi cant regression of infl ammatory lesion in the area of right cavernous sinus, thus verifying the effi cacy of the treatment applied. Th is paper shows that an extensive diagnostic schedule for THS must be conducted prior to therapeutic treatment, for the possibility of alternative diagnosis. Patients suspected of having THS require careful evaluation, appropriate treatment, and follow-up.

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Section: Discussionmentioning

confidence: 99%

Tolosa-Hunt Syndrome – Case Report

Penić

Lisak

Gregurić

et al. 2017

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“…The disorder is characterized by inflammatory granulomatous changes of unknown etiology in the cavernous sinus and superior orbital fissure which can extend into the orbit and continue intracranially [49].…”

Section: Tolosa-hunt Syndrome Etiologymentioning

confidence: 99%

“…THS is an episodically recurring pain in the orbit, accompanied by paresis of the oculomotor nerve and trochlear nerve and/or the abducens nerve [49].…”

Section: Symptomologymentioning

confidence: 99%

“…In addition to prompt improvement of symptoms within 72 hours after administration of cortisone, detection of inflammatory changes ( • " Fig. 2) is one of the essential diagnostic criteria [49]. To demonstrate granulomatous changes, contrast-enhanced images with fat saturation should be acquired using axial and coronal layer orientation ( • " Table 3).…”

Section: Imagingmentioning

confidence: 99%

See 1 more Smart Citation

Radiological Diagnosis and Differential Diagnosis of Headache

Langner¹,

Kirsch

2015

Fortschr Röntgenstr

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Headache is very common and affects almost everyone at some point. It is one of the most common disorders that leads patients to see their physician. All different forms have the nociception via trigeminal nerve fibers in common. Beside the clinical course headaches are classified as either primary or secondary, with the latter having an identifiable structural or biochemical cause. Imaging has a low diagnostic yield in primary headache but play an important role in the differential diagnosis of secondary forms. An overview of different forms of secondary headache is given, outlining diagnostic procedures and the morphologic imaging features of each syndrome. Key points: ??Headache can be differentiated in primary and secondary forms. ??Imaging plays an important role in differential diagnosis of secondary forms. ??Imaging should be performed in patients with concomitant systemic or neurologic symptoms. Citation Format: ??Langner S, Kirsch M, Hosten N Radiological Diagnosis and Differentialdiagnosis of Headache. Fortschr R?ntgenstr 2015; 187: 879???891

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“…that the IHS requires evidence of granuloma on either MRI or biopsy in order for a true diagnosis to be made. Others, such as Colnaghi et al 5 , interpret the second criterion more loosely and consider that the it can be filled by clinical demonstration of paresis of the third, fourth and/or sixth cranial nerves.…”

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confidence: 99%