Multiple nodular dural cavernous angiomas occluding superior sagittal sinus and destructing calvarium: Case report and literature review

Abstract

Dural cavernous angiomas (CAs) outside the middle cranial fossa are uncommon vascular lesions that generally present with benign clinical course compared to those within the middle cranial fossa. Aggressive invasion of these lesions is less common and mainly involves the skull. Dura sinus invasion and diffused nodular growth are exceedingly rare. We presented a case of a 33-year-old male with multiple nodular CAs growing in a sheet-like pattern along the falx cerebri and convexity dura, which occluded the superior sagittal sinus, destructed calvarium and were associated with an isolated skull CA on the right forehead. Both dura sinus and convexity skull were extensively invaded by these multiple dural CAs without obvious mass effect, suggesting an aggressive infiltration pattern. Invasive dural CAs have been predominantly observed in patients <40 year-old and might be along the extra-axial vasculature. Therefore, cavernous angiomas should be considered in the diagnosis of dura-based invasive lesions and a closer follow-up might be recommended for young patients with dural CAs adjacent to dura sinus or skull.