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Progressive tentorial cavernous malformation.

Furuta T, Nakada M, Watanabe T, Hayashi Y, Hamada J - Surg Neurol Int (2012)

Bottom Line: Postoperative MR imaging showed remarkable mass reduction and central necrosis of the lesion.After an additional 2 months, the lesion shrank in response to the radiosurgery.Gamma knife radiosurgery may prove highly effective for recurrent lesions.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Division of Neuroscience, Graduate School of Medical Science, Kanazawa University, Japan.

ABSTRACT

Background: Because extra-axial cavernous malformations (CMs) are rare, the common clinical course remains unclear. We report the case of a patient with progressive CM originating from the cerebellar tentorium.

Case description: A 64-year-old woman was admitted to our hospital with the complaint of diplopia. Magnetic resonance (MR) imaging revealed a lesion attached to the left cerebellar tentorium, close to the cerebral peduncle. This well-demarcated lesion rapidly enlarged for 3 months and eroded into the midbrain. Cerebral angiography showed a branch of the middle meningeal artery supplying the lesion and pooling of the contrast medium in the venous phase. A dark reddish and mulberry-like mass of the tentorium was observed intraoperatively, allowing the diagnosis of a tentorial CM. The feeding artery was identified in the tentorium and was coagulated. Postoperative MR imaging showed remarkable mass reduction and central necrosis of the lesion. However, the lesion recurred in 3 months; consequently, gamma knife radiosurgery was performed. After an additional 2 months, the lesion shrank in response to the radiosurgery.

Conclusions: We report an extremely rare case of tentorial CM which showed rapid growth in a short period. Coagulation of the feeding artery was not sufficient to control the lesion. Gamma knife radiosurgery may prove highly effective for recurrent lesions.

No MeSH data available.


Related in: MedlinePlus

Intraoperative view: A multilobulated, mulberry-like lesion attached to the cerebellar tentorium, which is a typical macroscopic feature of CMs
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Figure 3: Intraoperative view: A multilobulated, mulberry-like lesion attached to the cerebellar tentorium, which is a typical macroscopic feature of CMs

Mentions: The patient was placed in the supine position and a left orbitozygomatic craniotomy was performed. The lesion appeared as a multilobulated, mulberry-like mass located on the tentorium [Figure 3]. The intraoperative diagnosis was CM. The feeding artery, detected on the tentorium, was coagulated. However, the lesion was intentionally not removed to avoid hemorrhage in the CM, especially juxta-brainstem hemorrhage, which would be located in a blind area in this approach.


Progressive tentorial cavernous malformation.

Furuta T, Nakada M, Watanabe T, Hayashi Y, Hamada J - Surg Neurol Int (2012)

Intraoperative view: A multilobulated, mulberry-like lesion attached to the cerebellar tentorium, which is a typical macroscopic feature of CMs
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3307242&req=5

Figure 3: Intraoperative view: A multilobulated, mulberry-like lesion attached to the cerebellar tentorium, which is a typical macroscopic feature of CMs
Mentions: The patient was placed in the supine position and a left orbitozygomatic craniotomy was performed. The lesion appeared as a multilobulated, mulberry-like mass located on the tentorium [Figure 3]. The intraoperative diagnosis was CM. The feeding artery, detected on the tentorium, was coagulated. However, the lesion was intentionally not removed to avoid hemorrhage in the CM, especially juxta-brainstem hemorrhage, which would be located in a blind area in this approach.

Bottom Line: Postoperative MR imaging showed remarkable mass reduction and central necrosis of the lesion.After an additional 2 months, the lesion shrank in response to the radiosurgery.Gamma knife radiosurgery may prove highly effective for recurrent lesions.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Division of Neuroscience, Graduate School of Medical Science, Kanazawa University, Japan.

ABSTRACT

Background: Because extra-axial cavernous malformations (CMs) are rare, the common clinical course remains unclear. We report the case of a patient with progressive CM originating from the cerebellar tentorium.

Case description: A 64-year-old woman was admitted to our hospital with the complaint of diplopia. Magnetic resonance (MR) imaging revealed a lesion attached to the left cerebellar tentorium, close to the cerebral peduncle. This well-demarcated lesion rapidly enlarged for 3 months and eroded into the midbrain. Cerebral angiography showed a branch of the middle meningeal artery supplying the lesion and pooling of the contrast medium in the venous phase. A dark reddish and mulberry-like mass of the tentorium was observed intraoperatively, allowing the diagnosis of a tentorial CM. The feeding artery was identified in the tentorium and was coagulated. Postoperative MR imaging showed remarkable mass reduction and central necrosis of the lesion. However, the lesion recurred in 3 months; consequently, gamma knife radiosurgery was performed. After an additional 2 months, the lesion shrank in response to the radiosurgery.

Conclusions: We report an extremely rare case of tentorial CM which showed rapid growth in a short period. Coagulation of the feeding artery was not sufficient to control the lesion. Gamma knife radiosurgery may prove highly effective for recurrent lesions.

No MeSH data available.


Related in: MedlinePlus