title: Cavernous sinus hemangioma: a fourteen year single institution experience.
abstract: Cavernous sinus hemangioma (CSH) is a rare extra-axial vascular neoplasm that accounts for 2% to 3% of all cavernous sinus tumors. Their location, propensity for profuse bleeding during surgery, and relationship to complex neurovascular structures are factors which present difficulty in excising these lesions. The authors describe their experience of 22 patients with CSH over 14 years at a tertiary care center. Patients were managed with microsurgical resection using a purely extradural transcavernous approach (13 patients) and with Gamma Knife radiosurgery (GKRS; Elekta AB, Stockholm, Sweden) (nine patients). Retrospective data analysis found headache and visual impairment were the most common presenting complaints, followed by facial hypesthesia and diplopia. All but one patient had complete tumor excision in the surgical series. Transient ophthalmoparesis (complete resolution in 6-8 weeks) was the most common surgical complication. In the GKRS group, marked tumor shrinkage (>50% tumor volume reduction) was achieved in two patients, slight shrinkage in five and no change in two patients, with symptom improvement in the majority of patients. To our knowledge, we describe one of the largest series of CSH managed at a single center. Although microsurgical resection using an extradural transcavernous approach is considered the treatment of choice in CSH and allows complete excision with minimal mortality and long-term morbidity, GKRS is an additional tool for treating residual symptomatic lesions or in patients with associated comorbidities making surgical resection unsuitable.
authors: Department of Neurosurgery, Neurosciences Center, All India Institute of Medical Sciences, New Delhi 110029, India.
authors: Sumit
authors: S
authors: Bansal
authors: Department of Neurosurgery, Neurosciences Center, All India Institute of Medical Sciences, New Delhi 110029, India. Electronic address: surineuro@gmail.com.
authors: Ashish
authors: A
authors: Suri
authors: Department of Neurosurgery, Neurosciences Center, All India Institute of Medical Sciences, New Delhi 110029, India.
authors: Manmohan
authors: M
authors: Singh
authors: Department of Neurosurgery, Neurosciences Center, All India Institute of Medical Sciences, New Delhi 110029, India.
authors: Shashank Sharad
authors: SS
authors: Kale
authors: Department of Neurosurgery, Neurosciences Center, All India Institute of Medical Sciences, New Delhi 110029, India.
authors: Deepak
authors: D
authors: Agarwal
authors: Department of Neurosurgery, Neurosciences Center, All India Institute of Medical Sciences, New Delhi 110029, India.
authors: Manish Singh
authors: MS
authors: Sharma
authors: Department of Neurosurgery, Neurosciences Center, All India Institute of Medical Sciences, New Delhi 110029, India.
authors: Ashok Kumar
authors: AK
authors: Mahapatra
authors: Department of Neurosurgery, Neurosciences Center, All India Institute of Medical Sciences, New Delhi 110029, India.
authors: Bhawani Shankar
authors: BS
authors: Sharma
mesh_terms: D000328:Adult; D002426:Cavernous Sinus / Q000473:pathology* / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006392:Hemangioma, Cavernous / Q000175:diagnosis* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016634:Radiosurgery / Q000379:methods; D016896:Treatment Outcome; D019043:Vascular Neoplasms / Q000175:diagnosis* / Q000601:surgery*
keywords: Cavernous sinus; Extradural approach; Gamma Knife radiosurgery; Hemangioma; Transcavernous