Nishimura Fumihiko, Park Young-Soo, Nakagawa Ichiro, Yamada Shuichi, Nakase Hiroyuki, Nagatomo Yasushi
Department of Neurosurgery, Nara Medical University, Nara, Japan.
Department of Neurosurgery, Nara Medical University, Nara, Japan.
World Neurosurg. 2018 Apr;112:1-5. doi: 10.1016/j.wneu.2018.01.016. Epub 2018 Jan 8.
We report a rare case of hemorrhagic cavernous sinus hemangioma with sudden onset of abducens palsy.
Sudden onset of diplopia occurred in a 49-year-old female. Head computed tomography findings revealed a high-density mass in the right cavernous sinus with protrusion to the sphenoid sinus. Endoscopic endonasal surgery was performed, though early recurrence was noted. A Gamma Knife surgical procedure was then performed to prevent early recurrence after histopathologic confirmation of cavernous sinus hemangioma. Thereafter, the tumor was controlled and abducens palsy disappeared.
For treatment of cavernous sinus hemangioma, stereotactic radiosurgery should be considered as primary or adjuvant treatment in the very early phase after removal, to avoid early recurrence.
我们报告一例罕见的出血性海绵窦血管瘤，伴有外展神经麻痹突然发作。
一名49岁女性突然出现复视。头部计算机断层扫描结果显示右侧海绵窦有一高密度肿块，并向蝶窦突出。尽管注意到早期复发，但仍进行了鼻内镜手术。在组织病理学证实为海绵窦血管瘤后，接着进行了伽玛刀手术以预防早期复发。此后，肿瘤得到控制，外展神经麻痹消失。
对于海绵窦血管瘤的治疗，立体定向放射外科手术应在切除后的极早期被视为主要或辅助治疗，以避免早期复发。
