{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T14:59:00Z","timestamp":1782572340073,"version":"3.54.5"},"reference-count":40,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n<jats:title>Background: <\/jats:title>\n<jats:p>Immunoglobulin G4-related disease (IgG4-RD) is a rare systemic disease of unknown etiology. It is characterized by tissue infiltration caused by IgG4 plasma cells and sclerosing inflammation of various body organs. At present, there are very few reported cases of IgG4-RD invasion of cavernous sinus and the orbit.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st2\">\n<jats:title>Case Description: <\/jats:title>\n<jats:p>A 56-year-old female with a history of rheumatoid arthritis was presented with a gradual onset of right oculomotor, abducens, and trigeminal nerve deficits. Four weeks after the onset of symptoms, the patient developed gradual visual deficit. Following this, a trial of steroids was administered to the patient. However, the treatment did not work as expected and patient\u2019s condition worsened. She progressed on to suffer complete visual loss in the right eye. Extensive work-up conducted on her turned out to be nondiagnostic. After this, the patient was referred to us for our evaluation. Neuroimaging revealed a right-sided cavernous sinus and orbital apex lesion. Given the lack of diagnosis and response to steroid treatment, we recommended surgical intervention and performed a modified pterional and pretemporal approach with extradural anterior clinoidectomy and transcavernous approach. We performed a lesion biopsy and cavernous sinus decompression, which helped in the partial recovery of visual function. The pathology report was consistent with IgG4-RD.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st3\">\n<jats:title>Conclusion: <\/jats:title>\n<jats:p>IgG4-RD is a rare disease that occurs even less in combination with cavernous sinus and orbit invasion. The rarity of the disease and the diverse presentation of symptoms have sometimes caused delayed diagnosis and intervention. Patients who failed to respond to conservative management and patients in the fibrotic stage of the disease without other organ involvement may benefit from surgical intervention if amenable. Early suspicion, diagnosis, and intervention can facilitate better prognosis.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_859_2021","type":"journal-article","created":{"date-parts":[[2021,11,9]],"date-time":"2021-11-09T10:29:17Z","timestamp":1636453757000},"page":"557","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Immunoglobulin G4-related disease of the cavernous sinus with orbit invasion \u2013 A case report"],"prefix":"10.25259","volume":"12","author":[{"given":"Julie","family":"Mayeku","sequence":"first","affiliation":[{"name":"Department of General Surgery, Loma Linda University, California, United States."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy","family":"Deisch","sequence":"additional","affiliation":[{"name":"Department of Neuropathology and Human Anatomy, Loma Linda University, California, United States."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel Angel","family":"Lopez-Gonzalez","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Loma Linda University School of Medicine, Loma Linda, California, United States."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2021,11,8]]},"reference":[{"key":"10.25259\/SNI_859_2021\/ref-1","doi-asserted-by":"crossref","first-page":"1448","DOI":"10.1001\/archneur.61.9.1448","article-title":"Pupil-sparing, painless compression of oculomotor nerve by expanding basilar artery aneurysm. 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