DR. TEJASWINI MATSYARAJA

DR. RAMAN YENUGANDULA

Abstract

Lesions in the cavernous sinus usually present as multiple cranial nerve palsies. This is an unusual case of cavernous sinus meningioma encasing the internal carotid artery which presented as an isolated sixth nerve palsy with normal pupillary response. A 24-year young male presented with 1-year history of double vision and limitation in the outward movement of the left eye. Ocular motility showed limitation in movement of Left eye in Levoversion,levoelevation,levodepression. Pupils were reacting normally in both eyes. MRI brain with contrast revealed a lesion in the left cavernous sinus encasing the Internal carotid artery in keeping with cavernous sinus meningioma. Due to the surgically challenged location, the lesion was treated with Intensity-modulated radiation therapy/ The patient became symptomatically better after IMRT. Meningioma of the cavernous sinus is a challenging tumour. However, when picked up early in the course, has a very favourable prognosis in saving the life.