Malformación cavernosa de la región pineal: Caso clínico y revisión de la literatura

Abstract

Cavernous malformations rarely occur in the pineal region with only 21 reported to date. Although its diagnosis is not easy because of the extreme rareness of this condition, the presence of this lesion can be suspected based on its typical radiological findings. We report the case of a 57-year-old woman presented with desorientation, somnolence and diplopy. The CT-scan showed an acute hemorrhage in the pineal region and triventricular hydrocephalus. An MRI suggested a cavernous malformation. The patient was operated with total en-bloc removal of the lesion. We conclude that surgical exploration and total resection is the treatment of choice when the diagnosis of cavernous angioma is suspected of the basis of neuroimaging.

Microsurgical Management of Vascular Malformations of the Pineal Region

“…The pineal region is one of the uncommon locations for cavernous malformations, with only 21 cases reported so far according to a recent review. 12 However, we have to recognize that some big surgical series of pineal lesions include no mentioned cavernous malformations. 11,13,14,29,[38][39][40][41][42][43] Those vascular lesions are often misdiagnosed with germ cell tumors, choriocarcinomas (recurrent bleeding) or hemorrhagic pineal cysts, particularly when the clinical manifestation is related with intracranial hemorrhage.…”

“…Nevertheless, sometimes, when endovascular managements fail and/or if other alternatives are not available, microsurgical treatment may be indicated. [4][5][6][7][8][9][10][11][12][13][14] We present a retrospective review of the patients with vascular pineal malformations operated by the senior author (JH). Moreover, we report illustrative cases for the various types of vascular lesions with a careful analysis of the different microsurgical stages.…”