Cavernous Hemangioma of the Base of the Skull

Abstract

Cavernous h e m a n g i o m a of the base of the skull is a rare condition, even among the relatively unc o m m o n cranial hemangiomas. T h e subject has been reviewed b y Courville et al., 1 Wyke, ~~ Kleinsasser a n d Albrecht, ~ Kleinsasser 5 a n d Gerlach a n d Simon. ~ I n t r a c r a n i a l complications are unusual t h o u g h Politzer 7 described a case in which the t u m o r led to d e a t h without operation. Kessler et al. 4 reported the case of a n 8-year-old girl in whom fatal epidural bleeding occurred from a cavernous h e m a n g i o m a of the petrous bone. Graf 3 reported a case in which there was fatal hemorrhage into the 4th ventricle. T h e following case has unique features and the t u m o r reported is one of the few large hemangiomas successfully treated surgically.

Hemangiomas of the central nervous system in Japan: An epidemiological and clinicopathological study with special reference to venous and cavernous malformations

“…Also they usually present extreme difficulty in surgical removal. Pasztor et al [26] removed an extradural cavernoma after meticulous and laborious procedures. However, total removal of such lesions usually with involvement of the third to sixth cranial nerves, and presenting drastic hemorrhage during surgery can not be recommended.…”

“…Surgical results are usually excellent in those cases. Occasional association of a skin angioma may help in the diagnosis of this lesion, although it is not specific for this particular type of vascular malformation [12,26,28].…”

Efficacy of induced hypotension in the surgical treatment of large cavernous sinus cavernomas

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XTRAAXIAL cavernomas are rare vascular lesions comprising 0.4 to 2% of all intracranial vascular malformations 51 and most commonly occurring during the patient's fourth decade of life; women are predominantly affected. [1][2][3][4][5][6][7][37][38][39][40][41][42][43][44][45][46][47][48][49][50] Although extraaxial cavernomas share identical histopathological features with intraaxial lesions, they are a distinct clinical entity with respect to presentation, radiological features, and management. 51 The middle fossa is the site most commonly affected by these lesions, which arise from within the cavernous sinus.

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“…26,51 Although these lesions are well demarcated by the presence of a fibrous pseudocapsule as a dissection plane, the perioperative mortality rate is very high as a result of uncontrollable bleeding, with 12.5% in the 65 cases re-ported. [1][2][3][4][5][6][7][10][11][12][13][14][15][16][17][18][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][38][39][40][41][42][43][44][45][46][47][48][49]51 Surgery has frequently been halted due to profuse bleeding once the pseudocapsule is incised. 5,22,23,…”

Cavernous Angiomas of the Skull

“…Cavernous haemangiomas in the cutis and subcuticular layers occur relatively frequently (7,20,29,31,32). However, those of the skull and soft-tissues of the scalp arc rare (5,23,36).…”