Isolated tectal cavernomas: A comprehensive literature review with a case presentation

Area of Science:

• Neurology
• Neurosurgery
• Vascular Malformations

Background:

• Intracranial cavernous angiomas (ICCs) are vascular malformations with potential for severe outcomes.
• Brainstem cavernomas (BSCs) represent a critical subtype due to the brainstem's sensitivity.
• Tectal cavernomas (TCs) are rare ICCs located in the mesencephalic tectum.

Purpose of the Study:

• To report a rare case of a tectal cavernoma with intraventricular bleeding and Parinaud's Syndrome.
• To analyze factors influencing management outcomes in isolated tectal cavernomas.
• To evaluate the efficacy of surgical resection for tectal cavernomas.

Main Methods:

• Case report of a patient with a tectal cavernoma managed surgically.
• Literature review and analysis of 25 previously reported isolated tectal cavernoma cases.
• Correlation of clinical presentation, lesion characteristics, and treatment outcomes.

Main Results:

• The presented case involved a tectal cavernoma with intraventricular hemorrhage and Parinaud's Syndrome, successfully treated with surgical resection.
• Most symptomatic patients presented with headache, altered consciousness, or double vision.
• Hemorrhage was common (64%), with high recurrence rates (60%). Larger lesion size correlated with poorer outcomes.
• Surgical resection achieved complete recovery in approximately 79% of treated patients.

Conclusions:

• Tectal cavernomas are rare but can cause significant neurological deficits, including Parinaud's Syndrome.
• Surgical resection is an effective treatment for tectal cavernomas, leading to high rates of recovery.
• Lesion size is a critical factor determining the prognosis after treatment for tectal cavernomas.