Surgery on lesions involving cavernous sinus

Goel, Atul; Muzumdar, Dattatraya; Nitta, Junpei

doi:10.1054/jocn.2001.0882

Cited by 19 publications

(28 citation statements)

References 28 publications

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“…Exacerbation of symptoms in pregnant women have been reported, improving after delivery 2,3,9 . Presentation complaints most often consist of visual disturbances (retro-orbital pain and headache accompanied of reduced ocular motricity, ptosis, diplopia, exophtalmos and impaired visual acuity), mainly due to compressive effect or enclosure of neurovascular structures, namely the cranial nerves passing through the cavernous sinus [1][2][3][4]6,10 . Seizures, facial numbness and neuralgia may also occur 1,3,5 .…”

Section: Discussionmentioning

confidence: 99%

“…Erosion of the sphenoid bone can also be seen. DSA can be normal and show an avascular mass or a discrete to moderate tumoral blush, with feeding vessels originating from branches of the external carotid or cavernous internal carotid [2][3][4][5][6]9,10 . The internal carotid artery is often encircled by the lesion in its cavernous portion, usually maintaining its normal caliber.…”

Section: Discussionmentioning

confidence: 99%

“…Although parenchymal cavernomas are easily resected in most cases, surgical excision of cavernous angiomas is often challenging because of abundant operative bleeding, due to the vascular nature of these lesions [3][4][5]7,8,10 . Predominantly vascular masses and mostly organized ones can be found 9 .…”

Section: Discussionmentioning

confidence: 99%

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Cavernous angioma of the cavernous sinus: imaging findings

Mendonça¹,

Viana²,

Matsumine³

et al. 2004

Arq. Neuro-Psiquiatr.

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-Cavernous angiomas (cavernomas) of the cavernous sinus are uncommon, with only scattered reports in literature. Unlike their parenchymatous counterparts, they are intensely enhancing para-sellar masses, iso/hypointense in T1-and hyperintense in T2-weighted images. Differential diagnosis with parasellar meningiomas and schwannomas can be difficult. We report three cases of this condition, describing findings of diffusion-weighted imaging in this kind of lesion for the first time in literature.KEY WORDS: cavernous angioma, cavernous sinus, magnetic resonance imaging, computed tomography, angiography.Angioma cavernoso do seio cavernoso: achados aos exames de imagem RESUMO -Angiomas cavernosos (cavernomas) do seio cavernoso são lesões incomuns, com poucos relatos na literatura especializada. Ao contrário dos cavernomas parenquimatosos, são massas para-selares intensamente captantes, isointensas a hipointensas em T1 e hiperintensas em T2 nas imagens de ressonância magnética. O diagnóstico diferencial com meningiomas e schwannomas para-selares pode ser difícil. Relatamos os achados de imagem de três casos desta entidade, descrevendo os achados da ressonância magné-tica ponderada em difusão neste tipo de lesão pela primeira vez na literatura. PALAVRAS-CHAVE: angioma cavernoso, seio cavernoso, ressonância magnética, tomografia computadorizada, arteriografia.Cavernous angioma of the cavernous sinus is an extremely rare condition, and its differential diagnosis with tumors, namely para-sellar meningiomas and schwannomas, is often difficult. They are richly vascularized lesions, made up of a network of dilated, thin-walled vessels, and are responsible for less than one percent of all intracranial masses. The advent of magnetic resonance imaging (MRI) raised new diagnostic perspectives for this condition as we report in the study. METHODThis study was approved by the committee of Ethics of Clinica Radiologia Vila Rica, Brasilia DF, Brazil.Three female patients, with 42-years-old (patient 1), 45-years-old (patient 2) and 37-years-old (patient 3), are, respectively, presented with complaints of right-sided cranial nerves deficits (III nerve [patients 2 and 3], V1 nerve [patient 2] and VI nerve [patients 1 and 2]) and headaches. All of them underwent magnetic resonance imaging and cerebral digital subtraction angiography (DSA). Patients 2 and 3 were also submitted to computed tomography (CT). In all patients, MRI revealed well-delimited right para-sellar lesions, uniformly isointense in T1-weighted images and hyperintense in T2-, T2-and FLAIRweighted images, brightly enhancing after intra-vascular infusion of gadolinium. Diffusion-weighted sequence, performed in patient 3, revealed an isointense mass.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Cavernous angioma of the cavernous sinus: imaging findings

Mendonça¹,

Viana²,

Matsumine³

et al. 2004

Arq. Neuro-Psiquiatr.

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“…It is a really surgical challenge for surgeons when tumors invade cavernous sinus [2,[18][19][20]. Total resection of the tumor invading cavernous sinus is difficult and often causes complications [21][22][23][24]. In the past 3 decades, whether to totally remove tumor invading cavernous sinus or not aroused controversy.…”

Section: Tumor Variablesmentioning

confidence: 99%

Sphenoid wing meningiomas: Surgical strategies and evaluation of prognostic factors influencing clinical outcomes

Ouyang

Zhang

Wang

et al. 2015

Clinical Neurology and Neurosurgery

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“…Neurinomas of the trigeminal nerve branches and schwannomas of fifth and rarely third, fourth, or sixth cranial nerves may be located in the parasellar region [35,55]. Trigeminal neurinomas usually present with facial pain or paraesthesiae, with involvement of the motor division occurring late in the course [56]. CS hemangiomas are uncommon, representing about 2% of CS tumors.…”

Section: Primary Intracranial Parasellar Tumorsmentioning

confidence: 99%

Parasellar syndromes

Johnston¹

2002

Curr Neurol Neurosci Rep

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The parasellar compartments are located lateral to and on either side of the sella turcica. The cavernous sinuses are the most prominent anatomic feature of the parasella. Each sinus consists of a plexus of veins through which runs the intracavernous portion of the internal carotid artery. Ocular motor nerves three and four travel within the dural covering of the cavernous sinus to the superior orbital fissure, and cranial nerve six travels through the carotid sinus itself, giving rise to parasellar syndromes, which have distinctive clinical features. Ophthalmoplegia occurs as a result of damage to these ocular motor nerves and variable involvement of oculosympathetic nerves. Facial pain, dysesthesia, and paraesthesia are caused by damage to one or more of the divisions of the fifth cranial nerve, travelling in the dural wall of the cavernous sinus. Tumors, such as meningiomas, frequently cause parasellar syndromes, as do aneurysms of the intracavernous portion of the internal carotid artery, carotid-cavernous fistulas, and cavernous sinus thrombosis. Inflammatory conditions such as Tolosa-Hunt syndrome, ischemia to small vessels supplying the cavernous portion of the cranial nerves, and infections can cause this syndrome. Magnetic resonance imaging is the investigation of choice and therapy is specific to the cause of the parasellar syndrome, but now includes more aggressive endoscopic and microsurgical intervention, and radiosurgery.

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Surgery on lesions involving cavernous sinus

Cited by 19 publications

References 28 publications

Cavernous angioma of the cavernous sinus: imaging findings

Cavernous angioma of the cavernous sinus: imaging findings

Sphenoid wing meningiomas: Surgical strategies and evaluation of prognostic factors influencing clinical outcomes

Parasellar syndromes

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