1 Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China;
2 Department of Neural Reconstruction, Beijing Neurosurgery Institute, Capital Medical University, Beijing 100050, China
Complete resection of cavernous malformations in the hypothalamus: A case report and review of the literature
1 Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China;
2 Department of Neural Reconstruction, Beijing Neurosurgery Institute, Capital Medical University, Beijing 100050, China
摘要 Objective: Cavernous malformation (CM) originating from the hypothalamus is extremely rare and the deep location presents a challenge for its neurosurgical management. We report such a case to better understand its clinical features. Methods and Results: A 40-year-old male patient presented with impaired vision in the left eye. Magnetic resonance imaging (MRI) revealed a regularly shaped round lesion located in the suprasellar cistern, and a clinical diagnosis of hypothalamic CM was made. Complete microsurgical excision was performed via a right pterional craniotomy. The patient showed good recovery with no further visual acuity or field deficits postoperatively. No CM recurrence or rebleeding was seen on follow-up MRI scans performed over the course of two years. Conclusions: For patients with cavernous malformation in the hypothalamus, accurate preoperative diagnosis with complete surgical removal by an appropriate surgical approach can contribute to satisfactory outcomes.
Abstract: Objective: Cavernous malformation (CM) originating from the hypothalamus is extremely rare and the deep location presents a challenge for its neurosurgical management. We report such a case to better understand its clinical features. Methods and Results: A 40-year-old male patient presented with impaired vision in the left eye. Magnetic resonance imaging (MRI) revealed a regularly shaped round lesion located in the suprasellar cistern, and a clinical diagnosis of hypothalamic CM was made. Complete microsurgical excision was performed via a right pterional craniotomy. The patient showed good recovery with no further visual acuity or field deficits postoperatively. No CM recurrence or rebleeding was seen on follow-up MRI scans performed over the course of two years. Conclusions: For patients with cavernous malformation in the hypothalamus, accurate preoperative diagnosis with complete surgical removal by an appropriate surgical approach can contribute to satisfactory outcomes.
Xingchao Wang, Zhenmin Wang, Zhixian Gao, Pinan Liu. Complete resection of cavernous malformations in the hypothalamus: A case report and review of the literature[J]. 临床转化神经科学, 2016, 2(3): 199-202.
Xingchao Wang, Zhenmin Wang, Zhixian Gao, Pinan Liu. Complete resection of cavernous malformations in the hypothalamus: A case report and review of the literature. Translational Neuroscience and Clinics, 2016, 2(3): 199-202.
20161117201550 Figure 1 Magnetic resonance imaging (MRI) and computed tomography (CT) of the presurgical hypothalamic cavernous malformation. (a) Sagittal section of T1-weighted MRI shows mixed-signal, round lesions located in the suprasellar cistern. (b) Coronal section of gadolinium-enhanced T1 images show a heterogeneous mild enhancement of the lesion located in hypothalamus. (c) Axial section of T2-weighted MRI shows the lesion’s upward extension into the third ventricle. There was no typical hypointense signal rim around the lesion. (d) Unenhanced computed tomographic imaging reveals a hyperdense lesion in the suprasellar region.
20161117201607 Figure 2 Photomicrograph shows thin-walled cavernous vascular spaces with little intervening brain tissue (Hematoxylin-eosin stain, ×100).
20161117201643 Figure 3 Magnetic resonance imaging (MRI) of the postsurgical hypothalamic cavernous malformation at two-year follow-up. Axial section of T2-weighted (a) and gadolinium-enhanced T1-weighted (b) MRI reveals the complete removal of the hypothalamic cavernous malformation and no evidence of recurrence or rebleeding.
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2016, Vol. 2 
