Surgical Removal of Cavernous Angioma in the Midbrain: A Case Report

ABSTRACT

We report a case in which a cavernous hemangioma in the midbrain was completely removed. Two days prior to hospitalization, a 32-year-old female patient, who had complained of intermittent headache, presented with deteriorated consciousness. Neurological examination revealed anisocoria, no response to lights, diplopia in a superior and inferior direction, increased deep tendon reflexes, and an unceratin response to examination. Radiology revealed a deep cavernous hemagioma in the midbrain and there was evidence of recurrent bleeding, especially on MRI. To remove the cavernous hemangioma, she underwent extraventricular drainage(EVD), craniotomy(using the suboccipital transtentorial approach), and ventriculoperitoneal shunt and recovered. She has now been followed up for 1 year and 6 months, and is leading a normal life. We have concluded that excellent results may be possible with in the case of symptomatic cavernous hemangioma, an awareness precise anatomical location, a well designed approach and of possible neurologic deficits, this is so even in the midbrain.