Extracerebral cavernous angiomas of the middle fossa

Three cases of extracerebral cavernous angiomas of the cavernous sinus in the middle fossa are reported. These are rare lesions that primarily affect women and are usually associated with acute or subacute onset of visual symptoms: diplopia, exophthalmos, and decreased visual acuity. The growth of the lesion often erodes the bone in the area of the cavernous sinus. Angiography usually depicts a vascular mass. The lesions represent a formidable surgical problem because of their tendency to cause intraoperative life-threatening hemorrhages. Morbidity and mortality can be drastically reduced by not attempting to resect the lesion further after biopsy and by giving a course of radiation therapy before definitive surgical treatment.