case_images: PMC10899484_01
case_images: Initial MR images. Axial T2-weighted FLAIR image showing several small high-signal foci in the cerebral white matter (A). A fat-suppressed axial T2-weighted image shows a slight infiltrative change in the left orbital apex with intermediate signal intensity (B). Fat-suppressed contrast-enhanced axial and coronal T1-weighted images reveal mild perineural enhancement in the left orbital apex (yellow arrows), with no enhancement of the optic nerve (C-E). A suspicious extension into the left cavernous sinus through the superior orbital fissure (white arrow) is noted.
case_images: fneur-15-1326867-g001.jpg
case_images: PMC10899484_01_fneur-15-1326867-g001.jpg
case_images: fig1
case_images: Brain and orbital magnetic resonance imaging (MRI) demonstrated gadolinium enhancement of the left cavernous sinus, perineural enhancement of the optic nerve at the left orbital apex, and a few nonspecific high signal intensities in the periventricular white matter (Figure 1).
case_images: Two-month follow-up MR images after steroid pulse therapy. Fat-suppressed contrast-enhanced axial and coronal T1-weighted images show improved perineural enhancement in the left orbital apex (red arrows). The size of the left cavernous sinus appears to have reduced (red arrows) (A,B).
case_images: fneur-15-1326867-g002.jpg
case_images: PMC10899484_01_fneur-15-1326867-g002.jpg
case_images: fig2
case_images: Her pain resolved and gradually improved both clinically and radiologically (Figure 2).