Orbital phlebography in the diagnosis of painful ophthalmoplegia

Abstract

Three cases of painful ophthalmoplegia have been described in which symptoms suggesting a tumor of the orbit justified neuroradiological assessment. Phlebography in each case revealed stenosis of the superior ophthalmic vein in its third portion, and non-opicification of the cavernous sinus. Hirtz incidences revealed contralateral cavernous sinus opacification and venous drainage through the coronary sinus. These neuradiological findings helped to differentiate this syndrome from other affections which have similar signs and symptoms.

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

“…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.…”

NOSOLOGICAL ENTITIES?: The Tolosa-Hunt syndrome

“…Cerebral angiography has detected abnormalities in the intracavernous carotid artery in patients with Tolosa-Hunt syndrome 5-717 18 23 33 These have been described as “segmental narrowing”, “slight irregularity”, or “constriction”, and will resolve with corticosteroid therapy. The role of non-invasive vascular MRI techniques (MR angiography and venography) has not been defined in patients with the syndrome but these may prove to be valuable adjuncts in diagnostic evaluation.…”

The Tolosa-Hunt Syndrome—Literature Review: Seven New Cases and a Hypothesis

“…carotid angiography occasionally reveals narrowing or irregularity of the syphon (7,8,9,10,11). Orbital phlebography reveals an occlusion or stenosis of the anterior part of the superior orbital vein, sometimes accompanied by non-filling of the cavernous sinus (12,13,14,15). Thrombosis of the cavernous sinus is not specific for Tolosa-Hunt syndrome (14,16,17).…”