Tolosa-Hunt syndrome--case report

This is a case of a 38-year-old male who developed painful ophthalmoplegia two years after head injury. Under the impression of Tolosa-Hunt syndrome, the patient received long term unsustained oral steroid therapy for two years. Persistent growth of the parasellar lesion was confirmed by computed tomography. Due to the aggravation of the symptoms, craniotomy and partial parasellar granulation tissue extirpation were performed. Symptoms were then gradually subsided. The pathological study confirmed the presence of granulation tissue with marked acute and chronic inflammatory cells. No evidence of malignancy was noted. No further steroid treatment was rendered to the patient and he was well in the following 18 months after the operation.