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Updated: Jul 15, 2026
05:54
MRI-guided Focused Ultrasound Thalamotomy for Patients with Medically-refractory Essential Tremor
Published on: December 13, 2017
Thalamomesencephalic ossified cavernoma presenting with Holmes' tremor
Servet Inci1, Ozgur Celik, Figen Soylemezoglu
1Department of Neurosurgery, School of Medicine, Hacettepe University, 06510 Ankara, Turkey. servet@mailcity.com <servet@mailcity.com>
Surgical Neurology
|April 21, 2007
Summary
Surgical removal of a rare ossified midbrain cavernoma successfully cured Holmes
Area of Science:
- Neurology
- Neurosurgery
- Radiology
Background:
- Midbrain cavernomas are rare, and their association with Holmes' tremor is even rarer.
- This report details a unique case of a heavily ossified cavernoma presenting with Holmes' tremor, a clinical manifestation not previously associated with surgical cure.
- The unusual features of heavy ossification and Holmes' tremor in this cavernoma are discussed.
Observation:
- A 60-year-old woman presented with Holmes' tremor as the sole manifestation of a heavily ossified thalamomesencephalic junction cavernoma.
- Neuroimaging revealed characteristic features of an ossified cavernoma.
- Surgical removal was performed via a posterior interhemispheric approach in the sitting position.
Findings:
- Complete surgical excision of the ossified cavernoma was achieved.
- The patient experienced near-complete suppression of Holmes' tremor post-surgery.
- Histological examination confirmed the cavernoma and its ossified nature.
Implications:
- This case demonstrates the first reported cure of Holmes' tremor through surgical removal of a midbrain cavernoma.
- Ossified cavernomas, despite their rarity, present a characteristic MRI signature and are potentially curable.
- Highlights the importance of considering ossified cavernomas in the differential diagnosis of intracerebral hypointense lesions.
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