Cavernous hemangioma of the third cranial nerve: case report.
OBJECTIVE
The authors report a rare case of a cavernous hemangioma (CH) involving the third cranial nerve.


METHODS
A 25-year-old Caucasian woman presented with neuralgic facial pain that responded to pharmacological management. She had no neurological deficit. Magnetic resonance imaging scans revealed a space-occupying lesion in the interpeduncular cistern with no evidence of hemorrhagic event. Preoperative cerebrospinal fluid and blood samples were negative for cytology and tumor markers.


METHODS
The patient underwent craniotomy and exploration of the interpeduncular cistern. A lesion with the raspberry-like appearance characteristic of a CH was found emerging from between the fibers and completely encircling Cranial Nerve III. The surgeon decided to leave the lesion in place to avoid creation of a new neurological deficit in the young patient. The patient is asymptomatic with a stable radiological picture 18 months after surgery.


CONCLUSIONS
CH should be considered as a possible differential diagnosis of extra-axial space-occupying lesions along the course of the cranial nerves. Resection with resulting deficit may not be indicated in patients presenting with normal neurological function. Further research and longer follow-up periods are required to better understand the natural history of CH involving the cranial nerves.
Itshayek
Eyal
E
Department of Neurosurgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel. eyalit@md.huji.ac.il
Perez-Sanchez
Xicotencatl
X
Cohen
Jose E
JE
Umansky
Felix
F
Spektor
Sergey
S
D000328:Adult; D003390:Cranial Nerve Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D006392:Hemangioma, Cavernous / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D009802:Oculomotor Nerve / Q000000981:diagnostic imaging*; D015840:Oculomotor Nerve Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D011859:Radiography