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Updated: Nov 19, 2025
Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
A child dural-based occipital cavernoma with an accessory venous sinus
A Aulanier1, M Al Falasi1, N Serratrice1
1Department of Pediatric Neurosurgery, La Timone Hospital, Assistance Publique-Hôpitaux de Marseille, 264, rue Saint-Pierre, 13005 Marseille Cedex 5, France.
Insights
Diagnosing extra-axial cavernomas in children is challenging. This report details a rare pediatric dural cavernoma case successfully treated with surgical removal, highlighting the importance of timely intervention for developmental outcomes.
Area of Science:
- Pediatric Neurosurgery
- Neuroradiology
- Vascular Malformations
Background:
- Extra-axial cavernomas present diagnostic challenges in pediatric patients.
- Surgical decision-making for these lesions requires careful consideration.
Observation:
- A 33-month-old child presented with symptoms including asthenia, anorexia, and psychomotor regression.
- Imaging revealed a well-defined occipital extra-axial lesion that increased in size and showed hemorrhagic changes on follow-up MRI.
- Arteriography guided surgical planning, identifying an accessory venous sinus draining the lesion.
Findings:
- Total surgical removal of the dural cavernoma was achieved by clipping the accessory venous sinus, preserving the lateral sinus.
- Histopathological examination confirmed the diagnosis of cavernoma.
- The patient experienced no complications post-operatively.
Implications:
- This case represents a rare pediatric dural cavernoma associated with a distinct accessory venous sinus.
- Early diagnosis and management are crucial to prevent developmental impact in children.
- Histological confirmation is essential for definitive diagnosis and treatment planning.
Background:
The diagnosis of extra-axial cavernoma and surgical decision-making can be difficult on children.
Reported Case:
In this report we present the case of a 33-month-old child for whom the work up done for asthenia, anorexia and psychomotor regression reveals a well-defined occipital extra-axial lesion. A follow up MRI was performed two months later, revealing an increase in the size of the lesion associated with hemorrhagic changes. The surgical decision is performed after an arteriography; it allows the total removal of the lesion contained in a duplication of the dura mater, by placing a vascular clip on an accessory venous sinus draining the lesion, respecting the integrity of the lateral sinus. Histology confirms a cavernoma. No complication resulted from the surgical procedure. This atypical case of pediatric dural cavernoma associated with a well-defined accessory venous sinus in arteriography is to our knowledge the first description in the literature.
Conclusion:
Extra-axial cavernomas have a misleading presentation. The management of these lesions is of twofold interests: to avoid a repercussion on the development of these children, and to obtain histological confirmation.
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