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Introduction Tolosa-Hunt syndrome (THS) is a rare disorder indicated by recurrent painful ophthalmoplegia caused by non-specific inflammation of the cavernous sinus or superior orbital fissure (SOF).
4 cm diameter extra-axial fat-containing mass with scattered intralesional calcific deposits centered near the anterior clinoid process and overlying the superior orbital fissure (Figure 1).
If the penetration is parallel to the orbital roof, it will violate the cranium through the superior orbital fissure or optic canal, and usually does not result in bone fracture.
For example, the superior ophthalmic vein connects with the angular, supraorbital, and supratrochlear veins, and it crosses over the optic nerve through the superior orbital fissure and drains into the cavernous sinus.