title: Intracranial Hypertension Caused by Occipital Calvarial Hemangioma: Case Report.
abstract: BACKGROUND
  Primary intraosseous calvarial hemangiomas (PICHs) are generally rare and predominate (3:1) in women. Occurrence in the frontal and parietal bones is most common, but involvement of the occipital bone is exceedingly rare, representing 3 of 125 cases in a series of PICHs studied by Heckl et al. in 2000. Histopathology establishes the diagnosis of cavernous hemangioma, which represents the most common subtype of intraosseous hemangiomas. Others include sclerosing, cellular, and capillary. When they do occur in the calvarium, they are most often asymptomatic and discovered incidentally or due to a palpable defect in the skull.
  
  
  METHODS
  In this case, a calvarial hemangioma was found to be the cause of elevated intracranial pressure in a 35-year-old woman. Resection of the hemangioma and reconstruction of the calvarium provided a complete cure for her symptoms.
  
  
  CONCLUSIONS
  Primary intraosseous hemangiomas are rarely symptomatic but must be considered in the differential for calvarial lesions as part of safe surgical planning. Formulating an accurate differential diagnosis by acquiring proper imaging studies and specifically recognizing the classical "starburst" appearance, as well as considering the highly vascular pathology to avoid excess blood loss, is important. This unique case of a hemangioma-induced venous sinus compression and subsequent elevated intracranial pressure illustrates that hemangiomas can arise from any part of the calvarium and cause a wide variety of clinical symptoms.
authors.affiliation: Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Visish M
authors.initials: VM
authors.lastname: Srinivasan
authors.affiliation: Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Karas
authors.affiliation: Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Anish N
authors.initials: AN
authors.lastname: Sen
authors.affiliation: Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Jared S
authors.initials: JS
authors.lastname: Fridley
authors.affiliation: Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA. Electronic address: shankarg@bcm.edu.
authors.forename: Shankar P
authors.initials: SP
authors.lastname: Gopinath
mesh_terms: D000328:Adult; D005260:Female; D006392:Hemangioma, Cavernous / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D019586:Intracranial Hypertension / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D018810:Magnetic Resonance Angiography; D008279:Magnetic Resonance Imaging; D009765:Obesity / Q000150:complications; D009777:Occipital Bone / Q000000981:diagnostic imaging / Q000473:pathology*; D012888:Skull Neoplasms / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D015898:Tomography Scanners, X-Ray Computed
keywords: Calvarium; Cavernoma; Cavernous hemangioma; Hemangioma; Papilledema; Skull