+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

"Tram-track" sign and "donut configuration" in Tolosa-Hunt syndrome

"Tram-track" sign and "donut configuration" in Tolosa-Hunt syndrome

Rinsho Shinkeigaku 48(4): 271-274

We report unique MRI abnormalities seen in a patient with Tolosa-Hunt syndrome (THS). A 60-year-old woman was admitted for left eye symptoms, including periorbital pain, numbness around the left eyebrow, blurred vision, delayed light reflex and impairment of abduction. Laboratory studies were unremarkable except for elevated erythrocyte sedimentation rates. T1-weighted MRI showed a mass lesion in the left orbital apex. Fat-suppressed T2-weighted MRI showed a hyperintense parallel linear lesion on the left optic nerve and a ring lesion around it, producing the "tram-track" sign on the axial view and the "donut configuration" on the coronal view. A diagnosis of THS was made, and corticosteroid therapy was started. Symptoms were improved rapidly, and MRI abnormalities disappeared. Reevaluation of MRI which had been taken at the previous episode of the right eye symptoms two years before also showed the "tram-track" sign and the "donut configuration" on the right. These signs are easy to be recognized and well reflect the stage of the disease. They are thus useful for diagnosing THS and evaluating the effect of the treatment. One should pay attention not only to the cavernous sinus and orbital apex, but also to the optic nerve for the MRI diagnosis of THS.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 051010496

Download citation: RISBibTeXText

PMID: 18453161

DOI: 10.5692/clinicalneurol.48.271

Related references

The evaluation of ICHD-3 beta diagnostic criteria for Tolosa-Hunt syndrome: a study of 22 cases of Tolosa-Hunt syndrome. Neurological Sciences 36(6): 899-905, 2015

Painful ophtalmoplegia in children: Tolosa-Hunt syndrome or ophtalmoplegic migraine? FT Les ophtalmoplegies douloureuses de lenfant: place du syndrome de Tolosa-Hunt et de la migraine ophtalmoplegique. 2007

Painful ophthalmoplegia - Tolosa-Hunt syndrome FT Bolna oftalmoplegija - Tolosa-Huntov sindrom. 2007

Tram track sign. JournalofNeuro-Oncology85(1):75, 2007

The optic nerve tram-track sign. Radiology 227(3): 718-719, 2003

The tram-track sign: cortical calcifications. Radiology 231(2): 515-516, 2004

Tolosa-Hunt syndrome. Revista Clinica Espanola 213(2): E11-E12, 2013

Tolosa Hunt syndrome. Indian Journal of Ophthalmology 25(2): 22-26, 1977

The Tolosa-Hunt syndrome. Journal of Neurology Neurosurgery and Psychiatry 71(5): 577-582, 2001

The tolosa hunt syndrome. Fortschritte der Neurologie Psychiatrie und Ihrer Grenzgebiete 45(8): 429-440, 1977

The tolosa hunt syndrome. Orbital Cent Amsterdam Univ Eye Hosp Et Al. Proceedings Of The 3rd International Symposium On Orbital Disorders. Amsterdam, The Netherlands, Sept. 5-7, . Xviii 546p. Illus. Dr. W. Junk Bv Publishers: The Hague, The Netherlands; Boston, Mass., Usa. ISBN 90-6193-570-9: 383-391, 1978

Tolosa-Hunt syndrome. Nihon Rinsho. Japanese Journal of Clinical Medicine 35(Suppl. 1): 598-599, 1977

Tolosa-Hunt-syndrome. Wiener Medizinische Wochenschrift 130(19): 629-630, 1980

Tolosa hunt syndrome. Annals of Ophthalmology 7(8): 1087-1090, 1975