In an earlier study patients with symptoms of orbital venous vasculitis-that is, cases of characteristic orbital pain and pathologic orbital phlebograms-were found to have increased signs of cerebral atrophy compared with age-matched controls. One such patient with nine incidents of Tolosa-Hunt syndrome and advanced cerebral atrophy is reported, and his medical history and pathoanatomic studies are reported in detail. The cause of the atrophy was multiple small infarctions, which are suggested to be due to vasculitis. Other findings in this case support the hypothesis that the Tolosa-Hunt syndrome may be only one manifestation of a generalized vasculitis.
MilsteinBAMorretinLB.Report of a case of sphenoid fissure syndrome studied by orbital venography.Am J Ophthalmol1971;72:600–3.
2.
MuhletalerCAGerlockAJ.Orbital venography in painful ophthalmoplegia (Tolosa-Hunt syndrome).Am J Roentgenol1979;133:31–4.
3.
HannerzJEricsonKBergstrandG.Orbital phlebography in patients with Tolosa-Hunt's syndrome in comparison with normal subjects.Acta Radiol (Diagn)1984;25:457–63.
4.
HannerzJEricsonKBergstrandG.A new etiology for visual impairment and chronic headache.Cephalalgia1986;6:59–63.
5.
TolosaE.Periarteritic lesions of the carotid siphon with the clinical features of a carotid infraclinoidal aneurysm.J Neurol Neurosurg Psychiat1954;17:300–2.
6.
LakkeJPWF.Superior orbital fissure syndrome.Arch Neurol1962;7:289–300.
7.
SchatzNJFarmerP.Tolosa-Hunt syndrome: the pathology of painful ophthalmoplegia.Neuro-ophthalmological symposium.Miami: University of Miami1972;102–12.
HannerzJEricsonKBergstrandGBerggrenBMEdmanG.Computerized tomography of the brain of cases with venous vasculitis compared to a reference group.Acta Radiol (Diagn)1988(in press).
