Obaid Sami, Li Shu, Denis Daniel, Weil Alexander G, Bojanowski Michel W
Division of Neurosurgery, Hôpital Notre-Dame du CHUM, University of Montreal, Montreal, Quebec, Canada.
Division of Neurosurgery, Hôpital Notre-Dame du CHUM, University of Montreal, Montreal, Quebec, Canada ; Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Surg Neurol Int. 2014 Jul 30;5(Suppl 4):S203-7. doi: 10.4103/2152-7806.137754. eCollection 2014.
Cavernous angiomas (CAs) of cranial nerves are rare, and their occurrence on the third cranial nerve is particularly rare. Surgical management of such CAs involving the third nerve is controversial. We describe a case of a symptomatic CA of the oculomotor nerve and review the literature in order to ascertain the relevance of surgical intervention.
A 71-year-old male patient presented with a 2-month history of progressive oculomotor nerve paralysis. CA of the oculomotor nerve was suspected on magnetic resonance imaging (MRI). The patient underwent complete resection of the CA through a subtemporal approach, preserving the integrity of the nerve. Histopathological analysis confirmed the diagnosis of CA. Despite optimal resection, the patient did not improve postoperatively.
CAs of cranial nerves can cause rapid or progressive neurological deterioration. Whereas delayed treatment often leads to irreversible deficits, early nerve-sparing surgical excision of the CAs may potentially restore function.
颅神经海绵状血管瘤（CAs）较为罕见，而发生于第三颅神经的情况尤为罕见。此类累及第三神经的CAs的手术治疗存在争议。我们描述一例动眼神经症状性CAs病例并回顾相关文献，以确定手术干预的相关性。
一名71岁男性患者，有2个月进行性动眼神经麻痹病史。磁共振成像（MRI）怀疑为动眼神经CAs。患者通过颞下入路对CAs进行了完整切除，保留了神经的完整性。组织病理学分析证实为CAs诊断。尽管进行了最佳切除，但患者术后并未改善。
颅神经CAs可导致快速或进行性神经功能恶化。虽然延迟治疗常导致不可逆的功能缺损，但早期保留神经的CAs手术切除可能恢复功能。
