DOI: https://doi.org/10.36347/sjmcr.2025.v13i10.077

Pages: 2516-2518

Tolosa–Hunt syndrome (THS) is a rare, idiopathic granulomatous inflammation of the cavernous sinus, superior orbital fissure, or orbital apex, characterized clinically by painful ophthalmoplegia. We report the case of a 53-year-old woman with a five-month history of right periorbital headaches. MRI revealed enlargement of the right cavernous sinus with convex dural margins, iso- to slightly hyperintense T2 signal, and marked homogeneous enhancement after gadolinium administration. There was possible focal narrowing of the cavernous segment of the ipsilateral internal carotid artery, without bone erosion or mass effect. Follow-up MRI after four months of corticosteroid therapy demonstrated significant regression. This case highlights the role of MRI in diagnosing Tolosa–Hunt syndrome and monitoring therapeutic response.