Extradural transcavernous approach to cavernous sinus cavernous hemangiomas

Li, Meihua; Zhao, Jian‐Lan; Li, Yiyun; Zeng, Chunhui; Xu, Ganggang; Hong, Tao

doi:10.1016/j.clineuro.2015.06.004

Cited by 15 publications

(6 citation statements)

References 18 publications

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“…When reviewing the current data, most of the extra axial located cavernoma are diagnosed around and in the cavernous sinus, 1 2 3 4 5 6 7 8 9 10 11 parasellar, suprasellar, 12 13 14 15 16 17 18 in the cerebellopontine angle, 42 43 44 45 46 47 48 49 and lateral to midbrain and medulla.…”

Section: Discussion and Literature Reviewmentioning

confidence: 99%

Convexity Dura-Based Cerebral Cavernous Malformation Mimicking Meningioma: A Case Report and Literature Review

et al. 2022

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Cavernous angioma, cavernoma, cavernous hemangioma, also called cerebral cavernous malformation (when present in the brain), are benign vascular malformations, usually intraparenchymal; however, a few reported cases are in the extra-axial location—as middle cranial fossa, near the cavernous sinuses, and in the cerebellopontine angle—and are rarely reported as dura-based convexity lesion resembling meningioma. We report a giant dura-based, convexity, a cerebral cavernous malformation. We wish to notify the case as occurring at a rare location and a large-sized cerebral cavernous malformation. A case of young female presented with a long-standing history of headache. Computed tomography scan and magnetic resonance imagings (MRIs) suggested right occipital dura-based large mass lesion of approximately 5 cm in diameter. The lesion was excised and pathology studies confirmed the diagnosis of a cerebral cavernous malformation. A follow-up MRI confirmed total resection of the lesion and the patient had a smooth postoperative recovery.

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Section: Discussion and Literature Reviewmentioning

confidence: 99%

Convexity Dura-Based Cerebral Cavernous Malformation Mimicking Meningioma: A Case Report and Literature Review

et al. 2022

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“…As to giant CSHs, the optimal treatment remains controversial. Some research [2][3][4][5] has suggested that surgical resection is a favorable choice for treating giant CSHs, and that GKRS should be an additional tool for treating patients with residual lesions or associated comorbidities, making surgical resection unsuitable. In this retrospective study, we found staged GKRS was an effective treatment for giant CSHs with a low rate of adverse effects.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to GKRS, the reported therapies for giant CSHs include microsurgical resection, [2][3][4][5]28 CyberKnife therapy, [18][19][20] and radiotherapy. 22,23 Li et al 2 retrospectively reviewed surgical results of 47 patients with large-volume CSHs and gross-total resection in 26 (55.3%) cases with average intraoperative blood loss of 650 ml (range 100-3500 ml), and found that increased tumor size was a risk factor for unfavorable outcomes.…”

Section: Discussionmentioning

confidence: 99%

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Long-term outcomes of staged Gamma Knife radiosurgery for giant cavernous sinus hemangiomas: a single-center retrospective study

Yang

Wang

et al. 2022

Journal of Neurosurgery

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OBJECTIVE Cavernous sinus hemangiomas (CSHs) are rare benign tumors originating from the cavernous sinus. Gamma Knife radiosurgery (GKRS) has been recommended as a primary treatment for small- to medium-sized CSHs. The optimal treatment for giant CSHs is still controversial. In this study, the authors retrospectively reviewed the effectiveness and safety of staged GKRS treatment for giant CSHs. METHODS Twenty-two patients with giant CSH who received staged GKRS treatment in the Gamma Knife Treatment Center of Henan Province during the period from January 1, 2011, to December 31, 2018, were enrolled in this study. Six patients had received microsurgery before GKRS, the other 16 patients were diagnosed according to clinical symptoms and MR images. All of the enrolled patients received 2-stage GKRS, and the mean interval between the two GKRS treatments was 6.5 months (range 6–12 months). For the first GKRS, the median isodose line was 48% (range 45%–50%), the median marginal dose was 13 Gy (range 11.5–14 Gy), and the median coverage of CSHs was 80% (range 70%–88%). For the second GKRS treatment, the median isodose line was 50% (range 45%–55%), the median marginal dose to the CSHs was 10.5 Gy (range 9–12.5 Gy), and the median coverage of the CSHs was 88% (range 80%–94%). RESULTS All of the patients received an outpatient review of an enhanced MR image of the head and a clinical physical check every 6 months after the first GKRS treatment. The mean follow-up duration was 52 months (range 24–84 months). The tumor control rate was 100% 24 months after staged GKRS, and at the last follow-up the mean tumor shrinkage rate was 96.7% (range 90.6%–100%) and the mean residual CSH volume was 2.1 ml (range 0–8.5 ml). Twenty patients suffered central nervous system (CNS) injury symptoms to varying degrees before staged GKRS treatment. Complete symptom recovery was found in 11 (55%) patients, improved symptoms in 5 (25%) patients, and no change in 4 (20%) patients after treatment. Only 1 patient suffered temporary preexisting headache aggravation and 1 patient suffered temporary preexisting diplopia aggravation 1 week after receiving the first GKRS treatment. Subacute or chronic complications were not detected after staged GKRS. CONCLUSIONS Staged GKRS is an effective treatment for giant CSHs. Because of the impressively low incidence of adverse effects, staged GKRS may be considered as a primary treatment for giant CSHs.

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“…Similarly, Yin et al 53 carried out clinical study for the treatment of huge CS hemangiomas using epidural Dolenc's approach and reported that it was extremely useful in such clinical pathological settings. Li et al 54 introduced a pure transcavernous extradural technique to treat CS hemangiomas, and using this approach, they were able to complete access to tumor sections with acceptable morbidity and without tumor recurrence in patients. 54,55 Hsu et al 56 developed pre-temporal trans-cavernous trans-Meckel's trans-tentorial trans-petrosal (PCMTP) technique for management of meningiomas of the skull base and concluded that this combo skill technique (PCMTP) could be effective in such scenarios.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Surgical Approaches to Cavernous Sinus: A Narrative Review of the Literature with Anatomical Drawings.

Pahwa

Singh

Singh³

et al. 2022

J Neurol Surg A Cent Eur Neurosurg

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IIntroduction. The cavernous sinus (CS) is a paired venous sinus in the human brain that is classified as a true dural venous sinus rather than a venous plexus. The entire CS is separated by septa into two small cavities called caves. The CS has a very close resemblance to various key structures present in the head. The CS is a blood compartment that contains ligaments, endothelium, and trabeculae. It is clinically significant because of its position and relationship with several cranial nerves. Clinical implications. For effective management and treatment of CS syndrome, CS thrombosis, carotid-cavernous fistula, and other CS-related problems, CS surgery became necessary. As a result of the lack of sophisticated surgical techniques in the past, CS surgery was exceedingly challenging, complicated, and deadly. The surgery of CSs can benefit from a variety of surgical procedures, including extradural and intradural, endoscopic endonasal, rhomboid, and temporopolar trans cavernous approaches. In this review, numerous surgical procedures for CS are discussed along with their intended uses. Conclusions. A greater understanding of the CS was made possible by the quick modifications and improvements in surgical methods, which aided in neurosurgery procedures.

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Extradural transcavernous approach to cavernous sinus cavernous hemangiomas

Cited by 15 publications

References 18 publications

Convexity Dura-Based Cerebral Cavernous Malformation Mimicking Meningioma: A Case Report and Literature Review

Convexity Dura-Based Cerebral Cavernous Malformation Mimicking Meningioma: A Case Report and Literature Review

Long-term outcomes of staged Gamma Knife radiosurgery for giant cavernous sinus hemangiomas: a single-center retrospective study

Surgical Approaches to Cavernous Sinus: A Narrative Review of the Literature with Anatomical Drawings.

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