Intracranial Cavernous Hemangioma; Report of Theww Cases

Three cases of intracranial cavernous hemangioma which proved histologically and examined with carotid angiography and computed tomographic (CT) scan were reported. Of these cases, the hemangiomas were located in extradural middle fossa in one and other two were found in temporal and occipital lobes respectively. Conventional carotid angiography showed venous pooling or padding of the contrast media at the site of the angioma in all cases, and small feeding arteries from the internal carotid artery were found in extradural middle fossa lesion. With use of prolonged injection technique, angiographic signs appeared more conspicuously than other specific techniques (stereoscopic view, magnification angiography etc.). CT scan showed a high density area with marked contrast enhancement in uncalcified case, but no remarkable enhancement was seen in calcified case. Angiographic and CT scan findings which reported in the literature were reviewed. On the treatment, extirpation of the calcified intracerebral angioma is the method of choice for the amelioration of epileptic seizure or other clinical symptoms, and operative procedure is not so difficult. On the contrary, in the case of extradural middle fossa lesion, extirpation of the angioma is very difficult because of tremendous bleeding encountered at the operation. It was reported that the radiation therapy was very effective in such case. This effect was proved in our case too, that the postoperative tumor remnant observing in enhanced CT scan was disappeared by 4,000 rads X-ray irradiation. Now about 2 years after the treatment, no tumor shadow was found in CT scan even in contrast enhancement. We agree with the opinion of the recommendation of preoperative irradiation in such case.