Cerebellar cavernoma excision with a preserved venous anomaly: A case report in girl 28-year-old

• Published in: International journal of surgery case reports Vol. 107; p. 108332
• Main Authors: Irsyad, Muhammad Ari, Fitra, Fitra, Sanjaya, Firman Adi, Suroto, Nur Setiawan, Al Fauzi, Asra
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-06-2023; Elsevier
• Subjects: Case Report; Cerebral cavernoma; Severe headache; Venous anomaly; Severe headache; Cerebral cavernoma; Venous anomaly
• DOI: 10.1016/j.ijscr.2023.108332
• EISSN: 2210-2612

Cavernous malformations are congenital or acquired vascular abnormalities. They are uncommon entities with an incidence of 0.5 % of the general population and usually are unnoticed until a hemorrhagic event occurs. Cerebellar cavernomas (CCMs) account for 1.2 to 11.8 % of all intracranial cases and 9.3 to 52.9 % of all infratentorial cases. Cavernomas can be concurrently seen with developmental venous anomalies (DVAs) in 20 % (range 20 %–40 %) of cases, in which case they are known as mixed vascular malformations.
We report a case of a healthy young adult who presented with acute onset of headache, with characteristics of chronic headache that gets progressively worse. The patient complains of frequent dizziness when sitting and standing for a long time. Complaints have been felt for two years and have worsened for the past two weeks. Additional complaints are dizziness and nausea with intermittent episodes of vomiting for four days. Magnetic resonance imaging (MRI) revealed an underlying cavernoma that had bled and a coexisting DVA. The patient was discharged home with no deficits. Outpatient follow-up two months later showed no symptoms or neurologic deficits.
Cavernous malformations are congenital or acquired vascular anomalies that occur in approximately 0.5 % of the general population. Our patient likely had dizziness due to localization of the bleeding of the cavernoma on the left side of the cerebellum. In our patient, brain imaging revealed numerous abnormal blood vessels radiating from the cerebellar lesion, a highly suggestive of DVAs associated with cavernoma.
A cavernous malformation is an uncommon entity that might coexist with deep venous anomalies, making management more challenging.
•Cavernous malformation is a benign vascular lesion in the CNS and other organs such as the liver or skin. The CNS cavernoma accounts for 5-13% of all intracranial vascular anomalies, and they vary in size from a few millimetres to a few centimetres in diameter.•A cavernous malformation is an uncommon entity that might coexist with deep venous anomalies, making management more challenging.