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Updated: Apr 27, 2026

Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery

Role of Diffusion MRI Tractography in Endoscopic Endonasal Skull Base Surgery

Published on: July 5, 2021

Bilateral cranial hemophilic pseudotumor.

Qingsheng Xu¹, Pan Wu, Yiping Feng

¹From the Department of Neurosurgery, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou Zhejiang Province, People's Republic of China.

The Journal of Craniofacial Surgery

|July 10, 2014

Summary

Hemophilic pseudotumor, a rare complication of hemophilia, can occur in the skull. Surgical removal with factor replacement therapy offers a safe and effective treatment for cranial hemophilic pseudotumors.

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Area of Science:

Hematology
Neurosurgery
Radiology

Background:

Hemophilic pseudotumors are rare complications of hemophilia, arising from recurrent hemorrhage and hematoma enlargement.
Patients with severe hemophilia have a 1-2% chance of developing pseudotumors, which can cause bone destruction.
Cranial hemophilic pseudotumors are exceptionally rare, with only seven cases reported previously, typically in mild or moderate factor deficiencies.

Observation:

A 42-year-old male with mild factor VIII deficiency presented with a bilateral cranial pseudotumor.
Imaging revealed an extra-axial lesion with bone destruction and signs of chronic hemorrhage.
Histological examination confirmed old blood coagulum.

Findings:

The patient underwent surgical removal after receiving adequate factor VIII replacement therapy.
No recurrence was observed during a 3-year follow-up period.
This case highlights the successful management of an extremely rare cranial hemophilic pseudotumor.

Implications:

Cranial hemophilic pseudotumors, though rare, require prompt diagnosis and management.
Adequate factor replacement therapy is crucial for successful surgical intervention.
Surgical management, combined with factor therapy, is a safe and effective treatment for cranial hemophilic pseudotumors.