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Michael Rasper; Santosh Kesari, MD, PhD

Arch Neurol. 2008;65(12):1668.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

A 33-year-old woman with a history of migraines presented to her primary care physician with progressive retro-orbital headache, diplopia, and blurry vision. She was immediately examined by a neurologist and admitted to a local hospital to rule out cerebral aneurysm. A magnetic resonance (MR) angiogram revealed no aneurysm, but a subsequent MR image showed bilateral enlargement and enhancement in the pituitary gland, cavernous sinus, and optic nerves (Figure). The patient was hospitalized. Results of serologic testing for Lyme disease and lumbar puncture were negative (cytological testing and measurement of erythrocyte sedimentation rate were not performed). She was diagnosed as having Tolosa-Hunt syndrome (granulomatous inflammation of the cavernous sinus) and was treated with oral prednisone. Her headaches and visual difficulties improved and she was discharged to home receiving tapered oral prednisone therapy. Three days after discharge, she awoke with headache and complete loss . . . [Full Text of this Article]

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