DIAGNOSTIC AND MICROSURGICAL PRESENTATION OF INTRACRANIAL ANGIOLIPOMAS - CASE-REPORT AND REVIEW OF THE LITERATURE

Angiolipomas (ALs) are hamartomas composed of abnormally differentiate d vessels and mature adipose tissue. Although they are most commonly f ound in peripheral tissues, ALs sometimes grow in the spinal epidural space. Intracranial ALs (ICALs) are rare: only seven cases have been r eported in the literature. The authors describe the case of a 70-year- old woman who presented with ocular symptoms from a clinically and rad iologically progressing parasellar ICAL. The radiological as well as t he microsurgical findings are illustrated and compared with the seven previously published cases. The most frequent location of ALs is the s kull base, especially the parasellar region. Other ICALs were diagnose d as components of cerebral arteriovenous malformations and were not s ymptomatic by themselves. Neuroradiological studies of ICALs usually d emonstrate the characteristics of both adipose and vascular tissues. H owever, a review of the literature shows that the diagnosis had not be en suspected preoperatively in any of the cases. Operative description s emphasize that most neurosurgeons were caught off guard by the profu se bleeding and the unusual relationship of this unexpected lesion to the cavernous sinus, so that removal was rarely complete. The authors conclude that preoperative diagnosis of ICALs is achievable based on m agnetic resonance analysis, which should help optimize the microsurgic al management of these lesions.