Abstract

Purpose: To report a case presented with the clinical features of both orbital apex and cavernous sinus syndrome.

Methods: Review of clinical, orbital magnetic resonance imaging and magnetic resonance angiography findings.

Results: A 82-year-old man admitted to our clinic with left CN III, CN IV and CN VI nerve palsy and involvement of optic nerve (CN II), ophthalmic (V1) and maxillary (V2) branch of the trigeminal nerve. With the help of orbital magnetic resonance imaging and magnetic resonance angiography the diagnosis of intracavernous carotid artery aneurysm inTolosa-Hunt Syndrome was made. There is dramatic recovery in visual acuity and pain after the initiation of steroid therapy.

Conclusion: Neuroimaging studies may be helpful to explain the symptomatology and to localize the place of orbital and cavernous lesions. 

Key Words: Intracavernous carotid artery aneurysm, Tolosa-Hunt Syndrome, Neuroimaging