vrach
Forum Junior
Topics: 3
Posts: 79
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A 32 year-old woman developed a painful right eye and proptosis. Examination revealed normal vision but the movement of the right eye is restricted and the right forehead had decreased sensation to touch and pain. The left eye examination was normal.
Where is the lesion mosy likely to be?
A.Midbrain
B.Upper Pons
C.Cavernous Sinus
D.Superior Orbital Fissure
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| neuroguy
Forum Newbie
Topics: 3
Posts: 29
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Both C and D could be correct responses, but the MC is cavernous sinus thrombosis which affects CN's III, IV VI and V1
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| DiaHuq
Forum Elite
Topics: 46
Posts: 402
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the symptoms point to Tolosa-Hunt syndrome.but that could be either in the superior orbital fissure or cavernous sinus with proptosis indicating involvement of the orbit
http://www.emedicine.com/neuro/topic373.htm
cavernous sinus thrombosis would present with eyelid edema or chemosis and also visual acuity would be reduced.
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| vrach
Forum Junior
Topics: 3
Posts: 79
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You guys rock!!! The correct answer seems to be D. Cavernous sinus lesions are not usually associated with proptosis, except in the case of a carotid cavernous fistula. Source: http://www.mrcophth.com/finalmrcophthmcqss/40.htm...
There are more Q's there, enjoy. 
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