Abstract
INTRODUCTION AND IMPORTANCE: There exist some potential complications following chiari decompression surgery but tolosa hunt syndrome(THS) as a possible complication has never been reported in medical literature. Despite considered as a diagnosis of exclusion, tolosa hunt syndrome as late complication following posterior fossa decompression surgery for chiari 1 malformation is a potential differential. CASE SUMMARY: 20 years old male presented with headache and multiple ocular complaints 36 day after posterior fossa decompression surgery for Chiari I malformation. Diagnostic workup showed features suggestive of Tolosa hunt syndrome and was significantly improved after steroid trial. DISCUSSION: Tolosa hunt syndrome (THS)following posterior fossa decompression is very less likely but there always exist a meager possibility. Which National Organisation for Rare Disorder (NORD) has deemed it as rare diagnosis and adding to it, THS as late complication of posterior fossa decompression surgery is more unique. CONCLUSION: Tolosa hunt syndrome despite being a diagnosis of exclusion should be considered as potential complication of routine surgery like posterior fossa decompression which is done in case of Chiari malformation.