著者

Noriyuki WATANABE Masashi MIZUMOTO Taishi AMANO Hisayuki HOSOO Akinari YAMANO Alexander ZABORONOK Masahide MATSUDA Shingo TAKANO Yuji MATSUMARU Eiichi ISHIKAWA

出版者

The Japan Neurosurgical Society

雑誌

NMC Case Report Journal (ISSN:21884226)

巻号頁・発行日

vol.10, pp.337-342, 2023-12-31 (Released:2023-11-29)

参考文献数

17

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Cavernous sinus hemangioma (CSH) is a rare vascular malformation, arising from the cavernous sinus. Because of its anatomically complex location, a large lesion can cause a variety of symptoms due to cranial nerve compression. A 69-year-old woman with an unsteady gait was admitted to our hospital, and magnetic resonance imaging revealed an extra-axial giant tumor in the cavernous sinus and enlarged ventricles. A radiographic diagnosis of CSH was made. As the risk of surgical removal was considered high, the patient underwent intensity-modulated radiation therapy of 50.4 Gy in 28 fractions. The size of the tumor decreased markedly over time, and the symptoms improved soon after treatment. A 61.8% reduction in tumor size was confirmed immediately after irradiation, and a 75.9% reduction was revealed at a follow-up visit one year later. We reported a case of a giant CSH with hydrocephalus, where tumor shrinkage was confirmed immediately after radiation therapy, and the symptoms of hydrocephalus improved without surgical intervention.

著者

Yasunobu NAKAI Yoshiro ITO Masayuki SATO Kazuhiro NAKAMURA Masanari SHIIGAI Tomoji TAKIGAWA Kensuke SUZUKI Go IKEDA Satoshi IHARA Toshiyuki OKUMURA Masashi MIZUMOTO Koji TSUBOI Akira MATSUMURA

出版者

社団法人 日本脳神経外科学会

雑誌

Neurologia medico-chirurgica (ISSN:04708105)

巻号頁・発行日

vol.52, no.12, pp.859-864, 2012 (Released:2012-12-25)

参考文献数

26

被引用文献数

3

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A total of 29 cerebral arteriovenous malformations (AVMs) treated at the University of Tsukuba with multimodality treatment including proton beam (PB) radiotherapy for cerebral AVMs between 2005 and 2011 were retrospectively evaluated. Eleven AVMs were classified as Spetzler-Martin grades I and II, 10 as grade III, and 8 as grades IV and V. For AVMs smaller than 2.5 cm and located on superficial and non-eloquent areas, surgical removal with/without embolization was offered as a first-line treatment. For some small AVMs located in deep or eloquent lesions, gamma knife (GK) radiosurgery was offered. Some AVMs were treated with only embolization. AVMs larger than 2.5 cm were embolized to achieve reduction in size, to enhance the safety of the surgery, and to render the AVM amenable to GK radiosurgery. For larger AVMs located in deep or eloquent areas, PB radiotherapy was offered with/without embolization. Immediately after the treatment, 24 patients exhibited no neurological worsening. Four patients had moderate disability, and 1 patient had severe disability. Three patients suffered brain damage after surgical resection, and 2 patients suffered embolization complications. However, no neurological worsening was observed after either GK radiosurgery or PB radiotherapy, but 3 patients treated by PB radiotherapy suffered delayed hemorrhage. Fractionated PB radiotherapy for cerebral AVMs seems to be useful for the treatment of large AVMs, but careful long-term follow up is required to establish the efficacy and safety.