Intracranial Hypertension Caused by Occipital Calvarial Hemangioma: Case Report

Visish M. Srinivasan, Patrick J. Karas, Anish N. Sen, Jared S. Fridley, Shankar P. Gopinath

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Background Primary intraosseous calvarial hemangiomas (PICHs) are generally rare and predominate (3:1) in women. Occurrence in the frontal and parietal bones is most common, but involvement of the occipital bone is exceedingly rare, representing 3 of 125 cases in a series of PICHs studied by Heckl et al. in 2000. Histopathology establishes the diagnosis of cavernous hemangioma, which represents the most common subtype of intraosseous hemangiomas. Others include sclerosing, cellular, and capillary. When they do occur in the calvarium, they are most often asymptomatic and discovered incidentally or due to a palpable defect in the skull. Case Description In this case, a calvarial hemangioma was found to be the cause of elevated intracranial pressure in a 35-year-old woman. Resection of the hemangioma and reconstruction of the calvarium provided a complete cure for her symptoms. Conclusions Primary intraosseous hemangiomas are rarely symptomatic but must be considered in the differential for calvarial lesions as part of safe surgical planning. Formulating an accurate differential diagnosis by acquiring proper imaging studies and specifically recognizing the classical “starburst” appearance, as well as considering the highly vascular pathology to avoid excess blood loss, is important. This unique case of a hemangioma-induced venous sinus compression and subsequent elevated intracranial pressure illustrates that hemangiomas can arise from any part of the calvarium and cause a wide variety of clinical symptoms.

Original languageEnglish (US)
Pages (from-to)672.e1-672.e3
JournalWorld Neurosurgery
Volume91
DOIs
StatePublished - Jul 1 2016
Externally publishedYes

Keywords

  • Calvarium
  • Cavernoma
  • Cavernous hemangioma
  • Hemangioma
  • Papilledema
  • Skull

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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