Department of Neurology, Jinling Hospital, Nanjing University School of Medicine, 305# East Zhongshan Road, Nanjing, Jiangsu, China.
Neurol Sci. 2010 Dec;31(6):777-9. doi: 10.1007/s10072-010-0231-7. Epub 2010 Mar 3.
A 49-year-old female presented with recurrent intolerable right retro-orbital pain, ptosis and diplopia for 4 months. Neurological evaluation revealed right oculomotor nerve and abducent nerve injuries. Neuroimaging found enlarged right cavernous sinus, right intracavernous carotid dissection aneurysm and a stenosis proximal to it. Tolosa-Hunt syndrome (THS) was suggested and treated with steroid. The clinical symptoms were alleviated after the treatment. After 3 months of follow-up cerebral angiography showed the lesions of the right intracavernous carotid stenosis and the dissection almost disappeared. Therefore, we proposed that the dissection and the stenosis are directly induced by the inflammation of THS.
一位 49 岁女性因反复发作、无法忍受的右侧眼眶后疼痛、上睑下垂和复视 4 个月就诊。神经学评估显示右侧动眼神经和展神经损伤。神经影像学发现右侧海绵窦增大，右侧海绵窦内颈动脉夹层动脉瘤，其近端狭窄。考虑托洛萨-亨特综合征（THS），并给予类固醇治疗。治疗后临床症状缓解。随访 3 个月后，脑血管造影显示右侧海绵窦内颈动脉狭窄和夹层病变几乎消失。因此，我们认为 THS 的炎症直接导致了夹层和狭窄。
