Mortal Aneurysm Rupture in a Rare Case of Steroid-resistant Tolosa-Hunt Syndrome

Main Article Content

Anthoula C. Tsolaki
Galaktion Konstantinidis
Stavroula Koukou
Fotini Michali
Christina Manika
Nikolaos D. Michalis

Abstract

Tolosa-Hunt Syndrome is a rare condition characterized by painful ophthalmoparesis and idiopathic granulomatous inflammation of the cavernous sinus, classically extremely responsive to corticosteroid administration. We present a rare case of a 27-year-old man with Tolosa-Hunt Syndrome who did not respond to corticosteroids and the rupture of the co-existing internal carotid artery aneurysm caused his death.

Keywords:
Tolosa-Hunt syndrome, ophthalmoplegia, cavernous ICA aneurysm

Article Details

How to Cite
Tsolaki, A. C., Konstantinidis, G., Koukou, S., Michali, F., Manika, C., & Michalis, N. D. (2020). Mortal Aneurysm Rupture in a Rare Case of Steroid-resistant Tolosa-Hunt Syndrome. Asian Journal of Research and Reports in Neurology, 2(2), 1-6. Retrieved from http://journalajorrin.com/index.php/AJORRIN/article/view/30102
Section
Case Study

References

Tolosa E. Periarteritic lesions of the carotid siphon with the clinical features of a carotid infraclinoidal aneurysm. J Neurol Neurosurg Psychiatry. 1954;17:300–2.

International Headache Society. The International Classification of Headache Disorders, 3rd Edition. Cephalalgia 2018; 38:1–211.
DOI: 10.1177/0333102417738202

Amrutkar C, Burton EV. Tolosa-hunt syndrome. Statpearls Publishing; 2020.

Olsen K, Johnson A, Castillo-Jorge S, Bennett J, Ryan Mf, Olsen K, Et Al. Diagnosis and treatment of tolosa-hunt syndrome in the emergency department. Open J Emerg Med 2017;05:1–7.
DOI: 10.4236/Ojem.2017.51001

Msigwa Ss, Li Y, Cheng X, Msigwa Ss, Li Y, Cheng X. Tolosa hunt syndrome: Current diagnostic challenges and treatment. Yangtze Med. 2020;04:140–56.
DOI: 10.4236/Ym.2020.42014.

Evers S. Facial Pain: Overlapping Syndromes. Cephalalgia. 2017;37:705–13.
DOI: 10.1177/0333102417703761

Halabi T, Sawaya R. Successful Treatment of tolosa-hunt syndrome after a single Infusion of infliximab. J Clin Neurol 2018; 14:126–7.
DOI: 10.3988/Jcn.2018.14.1.126

Mazzotta G, Alberti A, Ps-Ha. Undefined. a case of tolosa-hunt syndrome responsive to azathioprine treatment. Cliggott Publ N.D; 2004.

Takasuna H, Sasaki R, Shiraishi M, Doi M, Wakui D, Ito H, Et Al. Steroid-resistant tolosa-hunt syndrome with a de novo intracavernous aneurysm: A case report. Surg Neurol Int. 2016;7:S779–84.
DOI: 10.4103/2152-7806.193925

Furukawa Y, Yamaguchi W, Ito K, Hamada T, Miyaji H, Tamamura H, Et Al. The Efficacy of radiation monotherapy for tolosa-hunt syndrome. J Neurol 2010;257: 288–90.
DOI: 10.1007/S00415-009-5335-8.

Wani Na, Jehangir M, Lone Pa. Tolosa-hunt syndrome demonstrated by constructive interference steady state magnetic resonance imaging. J Ophthalmic Vis Res 2017;12:106–9.
DOI: 10.4103/2008-322x.200171

Cakirer S. Mri findings in tolosa-hunt syndrome before and after systemic corticosteroid therapy. Eur J Radiol 2003;45:83–90.
DOI: 10.1016/S0720-048x(02)00012-8

Ravindran K, Schmalz P, Torun N, Ronthal M, Chang Y-M, Thomas Aj. Angiographic findings in the tolosa–hunt syndrome and resolution after corticosteroid treatment. Neuro-Ophthalmology. 2018;42:159–63.
DOI: 10.1080/01658107.2017.1365268

Kupersmith Mj, Stiebel-Kalish H, Huna-Baron R, Setton A, Niimi Y, Langer D, Et Al. Cavernous carotid aneurysms rarely cause subarachnoid hemorrhage or major neurologic morbidity. J Stroke Cerebrovasc Dis. 2002;11:9–14.
DOI: 10.1053/Jscd.2002.123969