Cavernous Sinus Cavernous Angioma Presenting As Painful Ophthalmoplegia: Report of a Rare Case Involving the Skull...

Cavernous sinus cavernous angiomas, also termed cavernous hemangiomas, are rare extra-axial vascular malformations with imaging and operative features that differ substantially from intraparenchymal cavernomas. Their presentation frequently mimics more common parasellar tumors, including meningiomas and schwannomas, rendering preoperative diagnosis difficult. These lesions are characteristically highly vascular, compressible, and prone to significant intraoperative hemorrhage. We report a rare case of cavernous sinus cavernous angioma presenting with severe ophthalmic-division trigeminal neuralgia and complete ophthalmoplegia. The lesion was managed with surgical decompression and tumor debulking through a fronto-orbito-zygomatic approach. Clinical presentation, neuroimaging findings, intraoperative characteristics, histopathologic confirmation, and postoperative outcome are described in this report. A focused review of the literature highlights the diagnostic pitfalls, operative considerations, and contemporary management strategies for this uncommon skull base pathology.