A Case Report of Cavernous Sinus Syndrome in a Patient With Takayasu's Arteritis

Authors

  • Dalia L. Rotstein MD,

    1. Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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  • Felix J. Tyndel MD,

    1. Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
    2. Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
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  • David F. Tang-Wai MD

    Corresponding author
    1. Division of Neurology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
    2. Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
    • Address all correspondence to D. Tang-Wai, UHN Memory Clinic, 399 Bathurst Street, Toronto, ON M5T 2S8, Canada.

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  • Conflict of Interest: Dr. Dalia Rotstein has received research support from the Multiple Sclerosis Society of Canada and has performed consulting for Sanofi-Aventis. She reports no conflict of interest. Dr. Felix Tyndel and Dr. David Tang-Wai report no conflicts of interest.

Abstract

Neurologists must entertain a broad differential diagnosis when considering a patient with cavernous sinus syndrome, including neoplasm, trauma, vascular causes, inflammatory processes, and infections. We report the case of a 37-year-old woman initially diagnosed with cavernous sinus syndrome, where subsequent investigations revealed findings of Takayasu's arteritis, a large vessel vasculitis. The patient also tested positive for perinuclear antineutrophil cytoplasmic antibodies, suggesting the possibility of a vasculitic spectrum disorder although no clinical features of Wegener's granulomatosis were present. Criteria for Takayasu's arteritis and its protean neurologic manifestations are reviewed. This case highlights the spectrum of vasculitic conditions that may be associated with cavernous sinus inflammation.

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