Are cavernous sinus hemangiomas and cavernous malformations different entities?

Gonzalez, L. Fernando; Leković, Gregory P.; Eschbacher, Jennifer; Coons, Stephen Joel; Porter, Randall W.; Spetzler, Robert F.

doi:10.3171/foc.2006.21.1.7

Cited by 77 publications

(75 citation statements)

References 20 publications

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“…11,13,16 It is important to note that extracerebral CHs such as those within the CS, optic nerve, optic disc, or retina should be differentiated from intracerebral CHs because of existing differences in clinical behavior, imaging, and response to treatment. 7 Various studies have noted a concomitance of pregnancy and the onset of symptoms associated with CH, 9,13,14 but the number of cases reported during pregnancy remains small. Our patient first experienced symptoms in the 2nd trimester of her pregnancy.…”

Section: Discussionmentioning

confidence: 99%

Conservative management of cavernous sinus cavernous hemangioma in pregnancy

Haber

Kesavabhotla

Ottenhausen

et al. 2014

JNS

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Key WorDs • cavernous sinus • cavernous hemangioma • pregnancy • oncologyAbbreviations used in this paper: CH = cavernous hemangioma; CS = cavernous sinus; VEGF = vascular endothelial growth factor. This article contains some figures that are displayed in color on line but in black-and-white in the print edition. J. S. Haber et al. 1310J Neurosurg / Volume 120 / June 2014 tion, she was referred to an outside neurologist who found ophthalmoplegia of the left eye and sensory deficit in the left V1 distribution.Clinical Course. The patient was then referred to the emergency department of the NewYork-Presbyterian Hospital where her examination was notable for 2 mm of ptosis in the left eye, impaired adduction, elevation, and depression of the left eye consistent with a partial left oculomotor nerve palsy and an inability to abduct the left eye, consistent with a complete left abducens palsy. Magnetic resonance imaging showed an expansile mass in the left CS (Fig. 1A) presumed to be a schwanomma.Several weeks later, the patient's left periorbital pain and numbness as well as the vertical motility of the left eye improved. However, repeat MRI showed a slight increase in lesion size and multiple serpentine T2 hyperintense structures, which together were suggestive of a CSCH (Fig. 1B). A cesarean section was recommended to reduce the risk of enlargement and hemorrhage during delivery. The neurosurgery team recommended no acute surgical treatment given the extent of the lesion within the CS, close follow-up, and postpartum imaging to assess for possible spontaneous involution.At 30 weeks of gestation the patient presented with progressive left orbital pressure, lid edema, worsened ptosis to 5 mm of the left eye and a new 2-mm anisocoria with mydriasis of the left eye. Repeat MRI revealed a significant enlargement of the lesion with extension to the orbital apex (Fig. 1C). There was severe compression of the left internal carotid artery and increased impingement of the left optic nerve. The patient was offered the option of immediate delivery, but she declined. A cesarean section was scheduled for 37 weeks.At 35 weeks of gestation, the patient was referred to a neuro-ophthalmologist for declining left visual acuity. Neuro-ophthalmic examination confirmed a complete left abducens palsy and partial left oculomotor palsy, including a mild adduction defect, mild ptosis and mydriasis, worse in light. However, there was no relative afferent pupillary defect. Visual acuity in the left eye improved with a +2 lens, consistent with blurry vision from a lens accommodation paresis associated with the oculomotor palsy rather than from optic nerve compression (Fig. 2).Postpartum Course. The patient underwent the scheduled cesarean section without complication. Two weeks postpartum, she developed complete ptosis and decreased supra-and infra-adduction of the left eye, consistent with worsened oculomotor nerve function. Furthermore, in addition to left mydriasis in the light, a relative miosis in dim light had developed, consistent with ...

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Section: Discussionmentioning

confidence: 99%

Conservative management of cavernous sinus cavernous hemangioma in pregnancy

Haber

Kesavabhotla

Ottenhausen

et al. 2014

JNS

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“…Representan el 3% de los tumores benignos y el 2% de los tumores localizados en esta región anatómica 7,11,23 . Tienen su origen en la arteria carótida interna intracavernosa, y adquieren su aporte vascular de ramas de la arteria meníngea media y de las ramas meníngeas accesorias 2,7,11,17,23 . Sólo secundariamente, cuando aumentan de tamaño y se convierten en grandes (entre 3,1-4 cm) o gigantes (más de 4 cm), se extienden e invaden la fosa craneal media.…”

Section: Generalidades Y Epidemiologíaunclassified

“…Entre el 80-95% aparecen en mujeres, con mayor incidencia en la población japonesa. Los síntomas se presentan entre los 30 y 60 años, si bien los pacientes más jóvenes suelen debutar con sintomatología más florida 7,11,22 . Los estrógenos podrían jugar un papel importante en la historia natural de estas lesiones.…”

Section: Generalidades Y Epidemiologíaunclassified

“…Se ha demostrado que durante el embarazo aumentan de tamaño, tornándose muchos de ellos sintomáticos o empeorando la clínica de los ya diagnosticados. En otros casos se produce involución después del parto, con una mejora de la sintomatología 2,7,11,17,23 .…”

Section: Generalidades Y Epidemiologíaunclassified

“…No obstante, la sintomatología y los déficits neurológi-cos no son exclusivos de los hemangiomas, sino que son 461 comunes para todos aquellos tumores que se originan o afectan secundariamente al seno cavernoso 2,5,7,18,19,22,23 .…”

Section: Presentación Clínicaunclassified

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Hemangioma gigante del seno cavernoso: Caso clínico

et al. 2009

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ResumenIntroducción. El hemangioma intracraneal es una tumoración vascular benigna que raramente afecta al seno cavernoso, por lo que es frecuentemente diagnosticado de forma errónea como meningioma.Caso clínico. Presentamos el caso de una mujer de 60 años que debutó con un cuadro de parálisis subaguda del tercer par craneal izquierdo. En neuroimagen, se evidenció una masa extraaxial localizada en la fosa craneal media, con extensión a las regiones selar y supraselar, e intenso realce homogéneo tras la administración de contraste. La arteriografía mostró discreto realce en fase arterial y venosa, y efecto de masa. Se realizó una embolización del tronco meningohipofisario izquierdo.Intervención y evolución. Se practicó una resección subtotal del tumor mediante un abordaje pterional izquierdo, persistiendo un pequeño resto intraselar. El diagnóstico anatomopatológico fue hemangioma. Tras la intervención la paciente no presentó nuevos déficits neurológicos.Conclusión. El hemangioma debe ser tenido en consideración al realizar el diagnóstico diferencial de los tumores que afectan al seno cavernoso. Su tratamiento constituye un reto quirúrgico para el neurocirujano, dada la complejidad de esta región anatómica y la gran tendencia del tumor a sangrar durante su disección.PALABRAS CLAVE: Hemangioma. Seno cavernoso. Giant cavernous sinus haemangioma. Case report SummaryIntroduction. Intracranial haemangioma is a benign vascular tumor which seldom affects the cavernous sinus region, being it frequently misdiagnosed as a meningioma.Case report. A 60-year-old woman presented with a subacute-onset third cranial nerve palsy. A giant extraaxial mass located in the middle cranial fossa which extended into the selar and supraselar areas was diagnosed. It showed homogeneous enhancement after contrast administration. The angiography revealed mild enhancement as well as indirect signs of mass effect, and a tumoral embolization was performed. Surgery and outcome. The tumor was partially removed through a left pterional approach, leaving an intraselar remnant. The patient had an uneventful postoperative course, and did not present new neurological deficits.Conclusions. The haemangioma must be considered in the differential diagnosis of cavernous sinus tumours. This entity represents a neurosurgical challenge, due to the complexity of this anatomical region and the trend of the tumour to bleed during its dissection.

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Combined Cerebral Microbleeds With Lacunar Infarctions in Familial Cerebral Cavernous Malformations

2019

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A 62-year-old man was admitted to the hospital because of dizziness, right-sided numbness, and mild weakness for 10 days. His medical history was unremarkable. The patient denied any history of smoking,drinking,orsubstanceuse.Hisvitalsignswerewithinnormalrange. The general medical examination results were normal. On neurological examination, he was conscious, alert, and oriented. No other focal neurologic deficits were noted except right-sided hypoesthesia. The

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Are cavernous sinus hemangiomas and cavernous malformations different entities?

Cited by 77 publications

References 20 publications

Conservative management of cavernous sinus cavernous hemangioma in pregnancy

Conservative management of cavernous sinus cavernous hemangioma in pregnancy

Hemangioma gigante del seno cavernoso: Caso clínico

Combined Cerebral Microbleeds With Lacunar Infarctions in Familial Cerebral Cavernous Malformations

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