Intracanal Optic Nerve Cavernous Hemangioma: A Case Report and Review of the Literature.

Abstract:

BACKGROUND:Cerebral cavernous malformations of the intracanalicular optic nerve are extremely rare lesions. Only a few case reports and 1 case series have been published. We report an additional case with atypical imaging and review the existing literature with attention to time to surgery and imaging characteristics. CASE DESCRIPTION:In a 38-year-old man with progressive visual field deficit, a lesion compressing the left optic nerve in the optic canal was diagnosed. On magnetic resonance imaging, this lesion had a homogeneous signal and was tentatively diagnosed as a meningioma. A left frontolateral craniotomy with extradural skull base approach with neuronavigation was performed for resection and definitive diagnosis of the lesion. Pathologic examination showed a lesion most consistent with a cavernous hemangioma. Follow-up magnetic resonance imaging at 6 months showed no remaining tissue or recurrence. Clinically, there was subjective and objective improvement of sight. CONCLUSIONS:A cerebral cavernous malformation should always be in the differential diagnosis of a lesion causing an optic neuropathy with visual acuity loss and visual field defect. Clinical presentation of an optic neuropathy requires medical imaging; magnetic resonance imaging is the modality of choice in the diagnosis of these lesions. The treatment of cerebral cavernous malformation is gross total resection.

journal_name

World Neurosurg

journal_title

World neurosurgery

authors

Algoet M,Van Dyck-Lippens PJ,Casselman J,Sirimsi S,Fletcher CDM,Van Den Berghe I,Vanopdenbosch L,De Muynck S,Vantomme N

doi

10.1016/j.wneu.2019.02.202

subject

Has Abstract

pub_date

2019-06-01 00:00:00

pages

428-433

eissn

1878-8750

issn

1878-8769

pii

S1878-8750(19)30642-4

journal_volume

126

pub_type

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