The radiological manifestations of Tolosa-Hunt syndrome

Objective: To study the radiological manifestation of Tolosa-Hunt syndrome, and to provide image basis for its clinical diagnosis. Methods: Twelve cases with clinically diagnosed Tolosa-Hunt syndrome from 1994 to 2002 were retrospectively studied, and CT, pre- and post-contrast MRI, DSA, and MRA were analyzed. Results: The appearances in 7 of the 12 cases were positive, while the other 5 cases showed negative findings. The positive appearances included the enlargement of one side of cavernous sinus and the mass at the orbit tip, which presented soft tissue density on CT images, isointensity or slight hypointensity on T1-weighted images and slight hypointensity, hyperintensity or isointensity on T2-weighted images. This abnormal tissue markedly increased in density or signal intensity on enhanced CT or MRI, associated with enhancement of adjacent dura mater. Conclusion: There is some abnormal radiological appearance in some cases of Tolosa-Hunt syndrome. CT and MRI present important value for the diagnosis. (authors)