Intrasellar cavernous hemangioma

2001 ◽  
Vol 94 (3) ◽  
pp. 520-522 ◽  
Author(s):  
Charles S. Cobbs ◽  
Charles B. Wilson

✓ The authors present a rare entity, an intrasellar cavernous hemangioma that on neuroimages mimicked a nonfunctioning pituitary macroadenoma in a patient with a known orbital hemangioma. Such lesions can grow extraaxially within the dural sinuses, particularly the cavernous sinus, and present like tumors. A better understanding of the neuroimaging, clinical, and anatomical features of these lesions may prevent difficulties in management.

1986 ◽  
Vol 65 (5) ◽  
pp. 716-718 ◽  
Author(s):  
Bruce Rosenblum ◽  
Allen S. Rothman ◽  
Charles Lanzieri ◽  
Sun Song

✓ The case of a Turner's syndrome patient with an intracavernous cavernous hemangioma is presented. The rarity of this lesion is stressed, as is surgical removal without postoperative deficit, the role of estrogens in the pathogenesis, and the clinical and radiological findings.


2000 ◽  
Vol 93 (supplement_3) ◽  
pp. 68-73 ◽  
Author(s):  
Pierre-Hugues Roche ◽  
Jean Régis ◽  
Henry Dufour ◽  
Henri-Dominique Fournier ◽  
Christine Delsanti ◽  
...  

Object. The authors sought to assess the functional tolerance and tumor control rate of cavernous sinus meningiomas treated by gamma knife radiosurgery (GKS). Methods. Between July 1992 and October 1998, 92 patients harboring benign cavernous sinus meningiomas underwent GKS. The present study is concerned with the first 80 consecutive patients (63 women and 17 men). Gamma knife radiosurgery was performed as an alternative to surgical removal in 50 cases and as an adjuvant to microsurgery in 30 cases. The mean patient age was 49 years (range 6–71 years). The mean tumor volume was 5.8 cm3 (range 0.9–18.6 cm3). On magnetic resonance (MR) imaging the tumor was confined in 66 cases and extensive in 14 cases. The mean prescription dose was 28 Gy (range 12–50 Gy), delivered with an average of eight isocenters (range two–18). The median peripheral isodose was 50% (range 30–70%). Patients were evaluated at 6 months, and at 1, 2, 3, 5, and 7 years after GKS. The median follow-up period was 30.5 months (range 12–79 months). Tumor stabilization after GKS was noted in 51 patients, tumor shrinkage in 25 patients, and enlargement in four patients requiring surgical removal in two cases. The 5-year actuarial progression-free survival was 92.8%. No new oculomotor deficit was observed. Among the 54 patients with oculomotor nerve deficits, 15 improved, eight recovered, and one worsened. Among the 13 patients with trigeminal neuralgia, one worsened (contemporary of tumor growing), five remained unchanged, four improved, and three recovered. In a patient with a remnant surrounding the optic nerve and preoperative low vision (3/10) the decision was to treat the lesion and deliberately sacrifice the residual visual acuity. Only one transient unexpected optic neuropathy has been observed. One case of delayed intracavernous carotid artery occlusion occurred 3 months after GKS, without permanent deficit. Another patient presented with partial complex seizures 18 months after GKS. All cases of tumor growth and neurological deficits observed after GKS occurred before the use of GammaPlan. Since the initiation of systematic use of stereotactic MR imaging and computer-assisted modern dose planning, no more side effects or cases of tumor growth have occurred. Conclusions. Gamma knife radiosurgery was found to be an effective low morbidity—related tool for the treatment of cavernous sinus meningioma. In a significant number of patients, oculomotor functional restoration was observed. The treatment appears to be an alternative to surgical removal of confined enclosed cavernous sinus meningioma and should be proposed as an adjuvant to surgery in case of extensive meningiomas.


1983 ◽  
Vol 59 (1) ◽  
pp. 150-152 ◽  
Author(s):  
Michele Occhiogrosso ◽  
Aristide Carella ◽  
Paola D'aprile ◽  
Giacomo Vailati

✓ A case of brain-stem hemangioma calcificans is described. The few cases reported in the literature prove the rarity of this tumor, which is considered a benign variant of cerebral cavernous hemangioma. Diagnosis and treatment of these tumors are briefly discussed with a review of the literature including 11 previous cases.


1974 ◽  
Vol 41 (4) ◽  
pp. 494-498 ◽  
Author(s):  
Louis Wener ◽  
Giovanni Di Chiro ◽  
Robert A. Mendelsohn

✓ An external carotid-cavernous fistula diagnosed by serial common carotid arteriography is reported. The diagnosis was reached on the basis of the difference in time between filling of the distal internal and external carotid arteries and the visualization of the fistula.


1998 ◽  
Vol 88 (1) ◽  
pp. 43-50 ◽  
Author(s):  
Klaus A. Leber ◽  
Jutta Berglöff ◽  
Gerhard Pendl

As the number of patients treated with stereotactic radiosurgery increases, it becomes particularly important to define with precision adverse effects on distinct structures of the nervous system. Object. This study was designed to assess the dose—response tolerance of the visual pathways and cranial nerves after exposure of the cavernous sinus to radiation. Methods. A total of 66 sites in the visual system and 210 cranial nerves of the middle cranial fossa were investigated in 50 patients who had undergone gamma knife treatment for benign skull base tumors. The mean follow-up period was 40 months (range 24–60 months). Follow-up examinations consisted of neurological, neuroradiological, and neuroophthalmological evaluations. The actuarial incidence of optic neuropathy was zero for patients who received a radiation dose of less than 10 Gy, 26.7% for patients receiving a dose in the range of 10 to less than 15 Gy, and 77.8% for those who received doses of 15 Gy or more (p < 0.0001). Previously impaired vision improved in 25.8% and was unchanged in 51.5% of patients. No sign of neuropathy was seen in patients whose cranial nerves of the cavernous sinus received radiation doses of between 5 and 30 Gy. Because tumor control appeared to have been achieved in 98% of the patients, the deterioration in visual function cannot be attributed to tumor progression. Conclusions. The structures of the visual pathways (the optic nerve, chiasm, and tract) exhibit a much higher sensitivity to single-fraction radiation than other cranial nerves, and their particular dose—response characteristics can be defined. In contrast, the oculomotor and trigeminal nerves have a much higher dose tolerance.


1971 ◽  
Vol 35 (2) ◽  
pp. 237-242 ◽  
Author(s):  
Donald J. Prolo ◽  
John W. Hanbery

✓ A technique for intraluminal occlusion of a carotid-cavernous sinus fistula with a balloon catheter is described. Passage of a balloon catheter into the cavernous carotid artery from the cervical carotid usually is easily accomplished. Inflation of the balloon with contrast material allows it to be visualized as the fistula is occluded. The simplicity and effectiveness of this method offer advantages over preexisting ones. Appraisal of its usefulness awaits further clinical trial.


1979 ◽  
Vol 50 (1) ◽  
pp. 110-114 ◽  
Author(s):  
Michael V. DiTullio ◽  
W. Eugene Stern

✓ A middle-aged woman, with a previous history of medically suppressed absence attacks, presented with mild changes in mental status and a skull film demonstrating several areas of mottled, granular, intracranial calcifications. These lesions, although readily visible on computerized tomography, appeared avascular during the course of cerebral angiography. At the time of surgery the masses, which were densely calcified and generally circular, demonstrated numerous areas of superficial, white, verrucous excrescences. Microscopic, pathological evaluation confirmed the diagnosis of hemangioma calcificans. The literature describing this rare entity is briefly reviewed.


1983 ◽  
Vol 58 (4) ◽  
pp. 611-613 ◽  
Author(s):  
Charles W. Kerber ◽  
William Manke

✓ A spontaneous cavernous sinus fistula developed following presumed sinusitis, and was found to originate not from the carotid artery but from a persistent trigeminal artery. The fistula was treated by introducing a detachable latex balloon via a femoral artery approach through the trigeminal artery and then into the cavernous sinus. Flow through the carotid, vertebral, and trigeminal arteries was preserved.


1987 ◽  
Vol 67 (6) ◽  
pp. 919-922 ◽  
Author(s):  
Shobu Shibata ◽  
Kazuo Mori

✓ Intracerebral cavernous hemangiomas are relatively easy to remove surgically, but extracerebral cavernous hemangiomas attached to the cavernous sinus are extremely difficult to treat. The authors report three cases of extracerebral cavernous hemangioma in the middle fossa that were treated with radiotherapy. The follow-up studies with serial computerized tomography (CT) scans during and after irradiation are described. In Case 1 radiotherapy after partial removal of the tumor decreased the tumor size on the contrast-enhanced CT scans, reduced its Hounsfield units on the nonenhanced CT scans, and facilitated later total tumor removal. In Case 2 the tumor responded to irradiation with approximately 3000 rads, showing significant reduction in size and Hounsfield units of the tumor. Subtotal removal was then possible. In Case 3 the tumor responded to irradiation, and the patient's vertigo improved after delivery of approximately 3000 rads. The CT scan showed significant reduction in the size and Hounsfield units of the tumor. No surgical intervention was deemed necessary. It is concluded that, in cases of extracerebral cavernous hemangioma with massive hemorrhage, irradiation with up to 3000 rads may be the treatment of choice. Radiation therapy offers an increased probability of total removal of the tumor and the possibility of eliminating surgery.


1971 ◽  
Vol 35 (6) ◽  
pp. 672-676 ◽  
Author(s):  
A. Loren Amacher ◽  
Larry K. Page

✓ Four patients with hydrocephalus due to membranous obstruction of the fourth ventricle are presented. This rare entity produced radiographic and clinical findings suggestive of posterior fossa tumor. Operative findings included normal cerebellar development and a translucent membrane just above the foramen of Magendie. Etiological possibilities are discussed.


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