Visual loss from cavernous hemangiomas of the middle cranial fossa

We studied a case of cavernous hemangioma of the middle cranial fossa. This rare tumor, of which only nine prior cases have been recorded, is characterized by insidious visual loss, multiple cranial nerve pareses, proptosis, papilledema, and bitemporal hemianopsia. Pituitary dysfunction has been noted in the more advanced cases. The female-male ratio has been 8:2; ages ranged from 30 to 62 years. The hemangiomas may occur on either side. Contrast-enhanced computed tomography can clearly demonstrate the presence of these lesions, but is not diagnostically specific. High-quality angiograms using magnification and subtraction techniques may show areas of dye retention in the cavernous spaces of the lesion. This tumor is amenable to successful excision, and early removal may prevent progressive visual loss.