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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

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.
Cephalalgia 1988 Mar
PMID:Pathoanatomic studies in a case of Tolosa-Hunt syndrome. 335 81

A 62-year-old man with ankylosing spondylitis and with a 3-year history of chronic paroxysmal hemicrania is presented. Because of his ankylosing spondylitis naproxen was prescribed; this decreased the attacks of headache to about 50%. However, treatment with indomethacin and steroids eliminated the attacks completely, the former drug in 24 h but only when the drug was taken; the latter drug was completely effective after a week but with an effect that lasted half a year after the medication was stopped. Orbital phlebography showed changes similar to those previously observed in patients with Tolosa-Hunt syndrome and cluster headache. Venous vasculitis thus seems to be associated with all three disorders and may be a factor of etiologic significance.
Cephalalgia 1987 Sep
PMID:Chronic paroxysmal hemicrania: orbital phlebography and steroid treatment. A case report. 365 1

Thirteen patients with cluster headache in an active stage were investigated with orbital phlebography. About 60% of the patients showed pathologic changes on the phlebograms, such as changes in the appearance of the superior ophthalmic vein. Five patients had pathologic changes on both sides and three patients on one side only. All patients with unilateral pathologic findings on orbital phlebography had the attacks on the same side. The phlebographic findings in these patients with cluster headache were very similar to those of patients with the Tolosa-Hunt syndrome. There is also some similarity in the symptoms in the two disorders. It has previously been suggested that the Tolosa-Hunt syndrome is caused by venous vasculitis, and the present findings to some extent support the idea that cluster headache may have the same etiology.
Cephalalgia 1987 Sep
PMID:Orbital phlebography in patients with cluster headache. 365 5

The Tolosa-Hunt syndrome is characterized by recurrent periods of painful ophthalmoplegia, dramatically ameliorated by steroid treatment. In half of the cases orbital phlebography shows characteristic changes. Ninety-six patients with orbital pain characteristic of the Tolosa-Hunt syndrome were submitted to orbital phlebography regardless of the existence of other symptoms. A pathologic phlebogram with changes typical of the Tolosa-Hunt syndrome was found in 50 patients. In 17 of these 50 patients the symptoms consisted of orbital pain only and no ophthalmoplegia. Twenty patients had pain and ipsilateral decrease of vision but no ophthalmoplegia, and 13 had painful ophthalmoplegia. Of 41 patients treated with steroid medication 39 responded dramatically with regard to the pain. Earlier findings indicate that the phlebographic changes are due to venous vasculitis, which thus may cause irreversible visual impairment but also chronic headache without ophthalmoplegia. It is concluded that the Tolosa-Hunt syndrome may be only one manifestation of a not uncommon disease.
Cephalalgia 1986 Mar
PMID:A new etiology for visual impairment and chronic headache. The Tolosa-Hunt syndrome may be only one manifestation of venous vasculitis. 369 95

Pain characteristics of the Tolosa-Hunt syndrome were abstracted from the observations of five patients with repeated incidents of painful ophthalmoplegia. The pain was experienced either as pressure behind the ophthalmoplegic eye or as boring pain in one orbital region, fluctuating in intensity, sometimes worsening to knife stab-like pain in the eye. The unilateral pain did not shift side during a solitary incident of painful ophthalmoplegia and was never completely absent. The pain was increased when the eyes were strained, when cold wind blew against the face, and when a change in the weather took place. It was accompanied by a feeling of swelling in the affected region, but not by nausea nor vomiting. Conventional headache drugs provided little relief. All cases experienced tenderness when pressure was applied to the ipsilateral supraorbital foramen. The pain was suggested to be related to an increased load on the impaired venous blood flow in the region of the superior orbital fissure.
Cephalalgia 1985 Jun
PMID:Pain characteristics of painful ophthalmoplegia (the Tolosa-Hunt syndrome). 401 17

The Tolosa-Hunt syndrome is a superior orbital fissure and/or anterior cavernous sinus syndrome. Because the etiology is unknown, the differential diagnosis is essentially one of localization. The pathological substrate consists of a non-specific inflammation. An exhaustive literature search up to 1 January 1981 yielded altogether 214 cases. Seven personal cases are reported. A consistent pathogenesis still lacking. Observations made in four cases led to the hypothesis that the syndrome results from dysregulation of the adaptation to stressful events, involving enhanced serotonergic activity which suppresses ACTH secretion and promotes non-specific inflammation of perivascular (venous/arterial) tissue.
Cephalalgia 1981 Dec
PMID:The Tolosa-Hunt syndrome--literature review: seven new cases and a hypothesis. 675 52

A 71-year-old man suffered from left-side throbbing headache over the region of the fifth cranial nerve first division, followed by left ptosis and ophthalmoplegia. Under tentative diagnosis of Tolosa-Hunt syndrome (THS), oral prednisolone 60 mg was given daily. His headache and ophthalmoplegia dramatically improved within 24 hours. Magnetic resonance (MR) imaging and computed tomography (CT) of the head were negative. However, irregularity in the siphon of the left internal carotid artery was disclosed by angiography. This case illustrates that angiography may be useful in diagnosing THS, when CT and MR imaging are negative.
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PMID:Angiographic findings in Tolosa-Hunt syndrome: a case report. 764 Nov 28

A 73-year-old man developed acute, painful, ophthalmoplegia. The pain improved with oral steroids and a diagnosis of Tolosa-Hunt syndrome was made. Review of his angiogram revealed a low flow dural arteriovenous shunt that drained posteriorly. Dural arteriovenous shunts may thus be another cause of "sinister" Tolosa-Hunt syndrome.
Headache 1994 Oct
PMID:Low flow dural arteriovenous shunt: another cause of "sinister" Tolosa-Hunt syndrome. 800 26

We report a rare case of Tolosa-Hunt syndrome in 48-year-old woman with terminal renal insufficiency and acute onset of headache and disturbances of the cranial nerves. MRI was performed to exclude cerebral disease. 14 days later the patient died from the terminal renal insufficiency. Neurohistopathological examination revealed pseudotumorous tissue components confirming the diagnosis of Tolosa-Hunt syndrome.
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PMID:[Magnetic resonance tomography in a case of the Tolosa-Hunt syndrome]. 824 4

A 23-year-old female with a six year history of migraine without aura twice developed a nearly complete internal and external III nerve paresis ipsilateral to her headache, two days after the onset of migraineous headache. An MR scan performed one week after the second episode showed a contrast enhanced lesion of the prepontine III nerve, where it enters the cavernous sinus on the left side. The headache, as well as the paresis ameliorated spontaneously. We suggest this is a further well documented case of "ophthalmoplegic migraine" which might reflect Tolosa-Hunt syndrome.
Headache 1993 Sep
PMID:A contrast enhanced lesion of the III nerve on MR of a patient with ophthalmoplegic migraine as evidence for a Tolosa-Hunt syndrome. 804 24


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