Cavernous Hemangiomas in the Cavernous Sinus

Cavernous Hemangiomas in the Cavernous Sinus AbstractOBJECTIVE:Cavernous hemangiomas located within the cavernous sinus are rare vascular tumors that are very difficult to remove because of severe intraoperative bleeding. The purpose of this study was to analyze the clinical, neuroimaging, and pathological features and the surgical treatment of these tumors.METHODS:Ten patients with cavernous hemangiomas in the cavernous sinus who were surgically treated from August 1985 to October 1997, in our hospital, were retrospectively studied.RESULTS:Among the 10 patients, total tumor removal was performed in four cases, partial removal in two cases, and tumor biopsies in four cases. The four patients who underwent total tumor removal experienced uneventful postoperative courses, with no postoperative neurological deficits for one patient, no new neurological deficits for two patients, and complete ophthalmoplegia and diminished sensation in the distribution of Cranial Nerve V1, for one patient. The two patients who underwent partial removal developed complete ophthalmoplegia and diminished sensation in the distribution of Cranial Nerve V1, after surgery, and one of them experienced contralateral paralysis. All four patients who underwent tumor biopsies experienced severe intraoperative tumor bleeding; one exhibited Cranial Nerve III, IV, and VI injuries after surgery.CONCLUSION:The features of prominent hyperintensity in T2-weighted scans, with well-defined borders in enhancing magnetic resonance imaging scans, or marked enhancement in computed tomographic and magnetic resonance imaging scans, with no tumor blush in angiographic analyses, facilitate the diagnosis of these tumors, These tumors can be divided into two subgroups on the basis of intraoperative findings and pathological features. We do not recommend division and piecemeal removal of the tumor during surgery if the main supplies of the tumor have not been interrupted. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Neurosurgery Oxford University Press

Cavernous Hemangiomas in the Cavernous Sinus

Cavernous Hemangiomas in the Cavernous Sinus

Jixin Shi, M.D., Ph.D., Chunhua Hang, M.D., Yunxi Pan, M.D., Chenji Liu, M.D., Zuxuan Zhang, Ph.D. Department of Neurosurgery, Jinling Hospital, School of Medicine College of Nanjing University, Nanjing, The People's Republic of China O B JE C T IV E : Cavernous hemangiomas located w ithin the cavernous sinus are rare vascular tumors that are very difficult to rem ove because of severe intraoperative bleeding. The purpose of this study was to analyze the clin ical, neuroimaging, and pathological features and the surgical treatm ent of these tumors. M E T H O D S : Ten patients w ith cavernous hemangiomas in the cavernous sinus w ho w ere surgically treated from August 1985 to O cto b er 1997, in our hospital, w ere retrospectively studied. RESU LTS: Among the 10 patients, total tum or rem oval was perform ed in four cases, partial rem oval in tw o cases, and tumor biopsies in four cases. The four patients w ho underw ent total tum or rem oval experienced uneventful postoperative courses, w ith no postoperative neurological deficits for one patient, no new neurological deficits for tw o patients, and com plete ophthalm oplegia and diminished sensation in the distribution of Cranial Nerve V, for one patient. The tw o patients who underw ent partial rem oval developed com plete ophthalmoplegia and diminished sensation in the distribution of Cranial N erve V-, after surgery, and one of them experienced contralateral paralysis. All four patients w ho underw ent tum or biopsies experienced severe intraoperative tumor bleeding; one exhibited Cranial N erve III, IV , and V I injuries after surgery. C O N C L U S IO N : The features of prom inent hyperintensity in T2-weighted scans, w ith well-defined borders in enhancing magnetic resonance imaging scans, or marked enhancem ent in com puted tom ographic and magnetic resonance imaging scans, w ith no tumor blush in angiographic analyses, facilitate the diagnosis of these tumors, These tumors can be divided into tw o...
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Publisher
Oxford University Press
Copyright
© Published by Oxford University Press.
ISSN
0148-396X
eISSN
1524-4040
D.O.I.
10.1097/00006123-199912000-00006
Publisher site
See Article on Publisher Site

Abstract

AbstractOBJECTIVE:Cavernous hemangiomas located within the cavernous sinus are rare vascular tumors that are very difficult to remove because of severe intraoperative bleeding. The purpose of this study was to analyze the clinical, neuroimaging, and pathological features and the surgical treatment of these tumors.METHODS:Ten patients with cavernous hemangiomas in the cavernous sinus who were surgically treated from August 1985 to October 1997, in our hospital, were retrospectively studied.RESULTS:Among the 10 patients, total tumor removal was performed in four cases, partial removal in two cases, and tumor biopsies in four cases. The four patients who underwent total tumor removal experienced uneventful postoperative courses, with no postoperative neurological deficits for one patient, no new neurological deficits for two patients, and complete ophthalmoplegia and diminished sensation in the distribution of Cranial Nerve V1, for one patient. The two patients who underwent partial removal developed complete ophthalmoplegia and diminished sensation in the distribution of Cranial Nerve V1, after surgery, and one of them experienced contralateral paralysis. All four patients who underwent tumor biopsies experienced severe intraoperative tumor bleeding; one exhibited Cranial Nerve III, IV, and VI injuries after surgery.CONCLUSION:The features of prominent hyperintensity in T2-weighted scans, with well-defined borders in enhancing magnetic resonance imaging scans, or marked enhancement in computed tomographic and magnetic resonance imaging scans, with no tumor blush in angiographic analyses, facilitate the diagnosis of these tumors, These tumors can be divided into two subgroups on the basis of intraoperative findings and pathological features. We do not recommend division and piecemeal removal of the tumor during surgery if the main supplies of the tumor have not been interrupted.

Journal

NeurosurgeryOxford University Press

Published: Dec 1, 1999

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