Li Zongze, Wang Chengjun, Ma Li, Wu Chunxue, Zhao Yuanli, Jiang Zhongli
Department of Neurosurgery, Peking University International Hospital, Peking University Health Science Center, Beijing 102206, PR China.
Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, PR China.
J Clin Neurosci. 2018 Dec;58:218-221. doi: 10.1016/j.jocn.2018.10.015. Epub 2018 Oct 16.
Dural cavernous angiomas (CAs) outside the middle cranial fossa are uncommon vascular lesions that generally present with benign clinical course compared to those within the middle cranial fossa. Aggressive invasion of these lesions is less common and mainly involves the skull. Dura sinus invasion and diffused nodular growth are exceedingly rare. We presented a case of a 33-year-old male with multiple nodular CAs growing in a sheet-like pattern along the falx cerebri and convexity dura, which occluded the superior sagittal sinus, destructed calvarium and were associated with an isolated skull CA on the right forehead. Both dura sinus and convexity skull were extensively invaded by these multiple dural CAs without obvious mass effect, suggesting an aggressive infiltration pattern. Invasive dural CAs have been predominantly observed in patients <40 year-old and might be along the extra-axial vasculature. Therefore, cavernous angiomas should be considered in the diagnosis of dura-based invasive lesions and a closer follow-up might be recommended for young patients with dural CAs adjacent to dura sinus or skull.
中颅窝以外的硬脑膜海绵状血管瘤（CAs）是罕见的血管病变，与中颅窝内的病变相比，其临床过程通常较为良性。这些病变的侵袭性生长较少见，主要累及颅骨。硬脑膜窦侵犯和弥漫性结节状生长极为罕见。我们报告了一例33岁男性病例，其多个结节状CAs沿大脑镰和凸面硬脑膜呈片状生长，阻塞上矢状窦，破坏颅骨，并与右前额孤立的颅骨CA相关。这些多发性硬脑膜CAs广泛侵犯硬脑膜窦和凸面颅骨，无明显占位效应，提示为侵袭性浸润模式。侵袭性硬脑膜CAs主要见于40岁以下患者，可能沿轴外血管分布。因此，在诊断以硬脑膜为基础的侵袭性病变时应考虑海绵状血管瘤，对于邻近硬脑膜窦或颅骨的年轻硬脑膜CAs患者，可能建议密切随访。
