Skull base and neck in granulomatosis with polyangiitis causing cavernous sinus syndrome and diabetes insipidus (coronal CT)

Coronal contrast-enhanced CT image of the skull base and neck (pre-cyclophosphamide treatment) in a woman with granulomatosis with polyangiitis causing cavernous sinus syndrome and diabetes insipidus. There is marked abnormal chronic inflammatory infiltration of the cavernous sinuses bilaterally (bold white arrow) and hypophyseal involvement (black arrow). Multiple lower cranial nerve palsies (Collet-Sicard syndrome) as a result of the skull base inflammatory involvement were evident on imaging, including right vocal cord palsy indicated by adducted right true vocal cord and enlarged right laryngeal ventricle (long white arrow).

(Source: Peters JE, Gupta V, Saeed IT, Offiah C, Jawad AS. Severe localised granulomatosis with polyangiitis [Wegener's granulomatosis] manifesting with extensive cranial nerve palsies and cranial diabetes insipidus: a case report and literature review. BMC Neurol 2018;18[1]:59. Creative Commons Attribution 4.0 International [CC BY 4.0] license, creativecommons.org/licenses/by/4.0.)