Dural Cavernous Hemangioma of the Cerebellar Falx : Case Report
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概要
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A 47-year-old man presented with a rare case of dural cavernous hemangioma of the cerebellar falx incidentally detected as a mass lesion in the posterior cranial fossa. Neurological examination revealed no deficits or physical symptoms. Computed tomography demonstrated a well-demarcated hyperdense mass, with no calcification, in the cerebellar vallecula. Magnetic resonance imaging showed the extra-axial mass as homogeneously isointense on T1-weighted images, and hyperintense on T2-weighted images, compared to the adjacent cerebellar parenchyma that had no hypointense halo. The cerebellar vermis was slightly compressed ventrally, the adjacent brain parenchyma was not swollen, and there was no evidence of hydrocephalus. The mass and the attached cerebellar falx were homogeneously enhanced by contrast medium. The dural enhancement was considered a dural tail. No other intracranial vascular malformations were found. The preoperative diagnosis was posterior cranial fossa meningioma attached to the cerebellar falx. Median suboccipital craniotomy exposed the reddish mass attached to the cerebellar falx. The arachnoid plane was well preserved. Total en bloc resection was performed with minimal blood loss. The postoperative course was unremarkable. The resected mass had a reddish-brown mulberry appearance, with spongy cross section with multiple blood-filled spaces. Histological examination identified dilated blood-containing channels lined with flattened endothelium and separated by fibrous tissue, but no luminal thrombus or hemorrhage. The histological diagnosis was dural cavernous hemangioma of the cerebellar falx. Preoperative radiosurgery or embolization is recommended for most of the dural cavernous hemangiomas, but surgery for the present dural cavernous hemangioma of the cerebellar falx was performed safely.
- 2009-09-15
著者
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ITO Masaki
Department of Neurosurgery, Asahikawa Red Cross Hospital
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KAMIYAMA Hiroyasu
Department of Neurosurgery, Asahikawa Red Cross Hospital
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NAKAMURA Takatoshi
Department of Neurosurgery, Asahikawa Red Cross Hospital
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NAKAJIMA Hideki
Department of Neurosurgery, Asahikawa Red Cross Hospital
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TOKUGAWA Joji
Department of Neurosurgery, Asahikawa Red Cross Hospital
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Tokugawa Joji
Department Of Neurosurgery Asahikawa Red Cross Hospital
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Nakamura Toshitaka
Department Of Neurosurgery Asahikawa Red Cross Hospital
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Ito Masaki
Department Of Anesthesiology Saitama Circulation And Respiratory Center
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Ito Masaki
Department Of Neurosurgery Asahikawa Red Cross Hospital
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Nakamura Takatoshi
Department Of Neurosurgery Asahikawa Red Cross Hospital
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Kamiyama Hiroyasu
Department Of Neurosurgery Asahikawa Red Cross Hospital
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Nakajima Hideki
Department Of Neurosurgery Asahikawa Red Cross Hospital
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Nakajima Hideki
Department Of Biomolecular Engineering Tokyo Institute Of Technology
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Ito Masaki
Department Of Anesthesiology Nagano Matsushiro General Hospital
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Kamiyama Hiroyasu
Department Of Neurosurgery Asahiakawa Red Cross Hospital
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