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Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
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Cavernous hemangioma within the cavernous sinus: illustrative case.

Omer F Bozkurt1, Pelin Kuzucu1, Muammer M Sahin2

  • 1Departments of Neurosurgery, Faculty of Medicine, Gazi University, Ankara, Turkey.

Journal of Neurosurgery. Case Lessons
|September 2, 2024
PubMed
Summary

Cerebral cavernous hemangiomas (CHs), a common brain vascular malformation, can occur in the sellar region. Endoscopic endonasal approach (EEA) facilitated gross-total resection (GTR) in a rare cavernous sinus CH case.

Keywords:
cavernous hemangiomacavernous sinusendoscopic endonasal surgerytotal excision

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Area of Science:

  • Neurosurgery
  • Vascular Neurology
  • Endoscopic Skull Base Surgery

Background:

  • Cerebral cavernous hemangiomas (CHs) are the most prevalent brain vascular malformations.
  • Intrasellar and parasellar regions are common extra-axial locations, though CHs in these areas are rare.
  • CHs in the cavernous sinus (CS) are exceptionally uncommon.

Purpose of the Study:

  • To report a rare case of a cerebral cavernous hemangioma (CH) in the left cavernous sinus (CS).
  • To evaluate the feasibility and outcomes of an endoscopic endonasal approach (EEA) for treating CS CH.
  • To review the literature on EEA for resecting sellar region CHs.

Main Methods:

  • A 41-year-old female with a year of headaches underwent surgery for a suspected CS CH.
  • An endoscopic endonasal approach (EEA) was performed by neurosurgery and otorhinolaryngology teams.
  • Gross-total resection (GTR) of the vascular lesion was achieved.

Main Results:

  • The lesion was identified as a blue-purple vascular malformation within the left CS.
  • Complete resection (GTR) of the CH was successfully accomplished using the EEA.
  • This case represents one of ten reported instances of GTR for sellar region CHs via EEA.

Conclusions:

  • Sellar region CHs can manifest with diverse clinical symptoms.
  • EEA may offer advantages over traditional cranial surgery for CS CH, potentially reducing complications and hospital stay.
  • Further research is warranted to establish EEA as a preferred surgical method for these rare lesions.