Difficult Surgical Aspect of a Compressive Hemangioma of the Cavernous Sinus in a Neurosurgical Setting in Senegal: About a Case and Review of the Literature

Abstract

Cavernous sinuses Hemangiomas (CSH) are rare benign extra-axial tumours, mainly affecting middle-aged women. Symptoms vary, but are usually due to a mass effect and include headaches, changes in vision and paralysis of the cranial nerves [1]. They account for 13% of all intracranial cavernous Hemangiomas, 3% of all benign tumours in the Cavernous sinus zone, 2% of all tumours in the cavernous sinus zone and 0.4% to 2% of intracranial vascular malformations. The occurrence of hemangioma within the cavernous sinus is rare. They do not cross the dural limits of the corpus cavernosum and can reach large sizes without symptoms. In the published literature, several short series describe the management of HSC, but despite advances in surgical techniques, they continue to pose a formidable challenge to surgical management, primarily because of the critical neurovascular environment. Current therapeutic modalities include microsurgical resection, fractional radiotherapy and stereotactic radiosurgery; total resection is curable but can be at the cost of intraoperative bleeding and new cranial nerve deficits [2,3]. Here we describe the clinical presentation, imaging results and difficult surgical management of a patient with cavernous sinusHemangioma enveloping the cavernous segment of the carotid artery, which made surgical resection difficult.