Cavernous hemangiomas in the cavernous sinus

OBJECTIVE: Cavernous hemangiomas located within the cavernous sinus are rar e vascular tumors that are very difficult to remove because of severe intra operative bleeding. The purpose of this study was to analyze the clinical, neuroimaging, and pathological features and the surgical treatment of these tumors. METHODS: Ten patients with cavernous hemangiomas in the cavernous sinus who were surgically treated from August 1985 to October 1997, in our hospital, were retrospectively studied. RESULTS: Among the 10 patients, total tumor removal was performed in four c ases, partial removal in two cases, and tumor biopsies in four cases, The f our patients who underwent total tumor removal experienced uneventful posto perative courses, with no postoperative neurological deficits for one patie nt, no new neurological deficits for two patients, and complete ophthalmopl egia and diminished sensation in the distribution of Cranial Nerve V-1 for one patient. The two patients who underwent partial removal developed compl ete ophthalmoplegia and diminished sensation in the distribution of Cranial Nerve V-1 after surgery, and one of them experienced contralateral paralys is. All four patients who underwent tumor biopsies experienced severe intra operative tumor bleeding; one exhibited Cranial Nerve III, IV, and VI injur ies after surgery. CONCLUSION: The features of prominent hyperintensity in T2-weighted scans, with well-defined borders in enhancing magnetic resonance imaging scans, or marked enhancement in computed tomographic and magnetic resonance imaging scans, with no tumor blush in angiographic analyses, facilitate the diagnos is of these tumors. These tumors can be divided into two subgroups on the b asis of intraoperative findings and pathological features. We do not recomm end division and piecemeal removal of the tumor during surgery if the main supplies of the tumor have not been interrupted.