Díaz CA, Zottis GC, Rehder R, Borba LAB

Language: Spanish
References: 32
Page: 258-268
PDF size: 411.22 Kb.

ABSTRACT

Introduction: Cavernous brain malformations (cavernous angiomas), cavernomas, as well as occulted angiographic vascular malformations presents 0.3 – 0.5% of incidence and compose 10-20% of all vascular malformations. The majority of the respective pathology locates in supratentorial compartment (80%), followed by infratentorial (15%) and spinal cord (5%). Unusually taking place in the cranial nerves, cavernous angioma generally manifests as a subtle or local deficit. Objective: To analyze surgical techniques, results, and complications on cranial nerves presenting cavernous angiomas. Methods: Clinical review based on 5 patients presenting cavernous angioma on optic tract, optic nerve, oculomotor nerve, trigeminal nerve, and external oculomotor nerve, whereas data were obtained about lesion site, symptoms, surgical techniques, results, and complications. Results: Five patients under study were composed by two female (19 and 40 years old) and three male (35, 46, and 56 years old). Cranial nerves involved were optic tract, optic nerve, oculomotor nerve, trigeminal, and external oculomotor. The clinical manifestations affecting the optic tract and optic nerve were visual field diminished; oculomotor nerve affected developed diplopia; trigeminal nerve involvement presents as headache and facial paresthesia; external oculomotor nerve manifests as diplopia. Lesions located in the optic tract, optic nerve, and oculomotor were submitted to an orbito-zigomatic craniotomy; lesions located in the trigeminal nerve and external oculomotor nerve were submitted to extended retromastoidea craniotomy. All lesions were completely removed. The surgical procedures did not provoke any complication in those cases described. In general, symptoms improved after surgical procedures, except in those cases where lesions were located in oculomotor nerve, presenting complete third nerve lesion was sequel, recovering after a month. Conclusion: Cavernous angiomas involving cranial nerves are considered rare lesions, radiological characteristics suggest such lesions, although do not define them. Definitive diagnosis requires surgical procedure, complete resection in symptomatic patients consist in the best option to avoid worsen of the symptoms and recidivated lesion, knowing that the same lesion may be safely removed and at the same time preserve cranial nerve function.

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