Papilledema with acute profound visual loss in capillary haemangioma of the sphenoid sinus with sellar and parasellar extensions – a triple rarity presentation

Abstract

Intracranial capillary haemangioma (ICH) is rare. We report a unique case of a young man with ICH who was presented with papilledema and acute profound visual loss. A 27-year-old man presented with bilateral eye reduced vision for 2 weeks with headaches. Examination showed optic disc swelling with severe visual loss. Neuroimaging revealed a vascular tumour epicentre at the sphenoid sinus with sellar and parasellar extensions. The patient developed massive bleeding during transsphenoidal surgery, in which intraarterial embolization was done, followed by a second surgery. Histopathology revealed benign capillary haemangioma. There was minimal visual improvement. He then developed tumour recurrence at 4 months postoperatively. ICH may cause rapid and acute blindness. Management is challenging with a guarded visual prognosis.