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Extra-axial cavernous hemangiomas involving the dural sinuses
F B Meyer1, D Lombardi, B Scheithauer
1Department of Neurosurgery, Mayo Clinic, Rochester, Minnesota.
Journal of Neurosurgery
|August 1, 1990
Summary
Extra-axial cavernous hemangiomas, rare intrasinus lesions, can be successfully resected with low morbidity. Surgical planning with MRI and extradural approaches improve outcomes for these "sinus cavernomas".
Area of Science:
- Neurosurgery
- Vascular Neurology
Background:
- Extra-axial cavernous hemangiomas are rare, historically associated with high surgical risks.
- Intrasinus cavernous hemangiomas present unique challenges compared to intra-axial counterparts.
Observation:
- This study reviewed eight intrasinus cavernous hemangiomas (six cavernous sinus, one petrosal sinus, one torcula).
- Magnetic resonance imaging (MRI) proved crucial for surgical planning.
- Extradural removal of the sphenoid bone aided neurovascular preservation in cavernous sinus cases.
Findings:
- Successful tumor removal was achieved in six of eight patients, with no mortality and low morbidity.
- Subtotal resection occurred in two cases due to hemorrhage or misdiagnosis.
- Proposed term "sinus cavernoma" highlights their intrasinus origin and distinct characteristics.
Implications:
- Surgical resection of intrasinus cavernous hemangiomas is feasible and can yield favorable outcomes.
- Advanced imaging and tailored surgical techniques are vital for successful management.
- Distinguishing these from intra-axial lesions is critical for appropriate treatment strategies.