Abstract
Cavernous malformation (CM) is a vascular malformation disorder characterized by a berry-like mass of expanded blood vessels. CM, originating from the optic chiasm. usually leads to chiasma syndrome presenting with bitemporal hemianopsia. We report a 28-year-old male presenting with left homonymous hemianopsia. Magnetic resonance imaging (MRI) revealed an occupied lesion located in the right side of the optic chiasm, and a clinical diagnosis of chiasmal CM was made. Microsurgical excision was performed via anterolateral pterional craniotomy. The patient showed good recovery with slight improvement of the visual field deficits after the operation. No CM recurrence was discovered during the follow-up MRI scans.
Highlights
Intracranial cavernous malformations (CMs) are not uncommon in the clinic and account for 10 to 20% of intracranial vascular diseases [1]
We describe a case with a CM located on the right side of the optic chiasm, in which the patient presented with bilateral left homonymous hemianopsia in the visual field examination
The sixmonth follow-up showed that his best-corrected visual acuity was 0.8 in both eyes, the headache had disappeared, visual field deficits were slightly improved, and no CM recurrence was found by an Magnetic resonance imaging (MRI) scan
Summary
Intracranial cavernous malformations (CMs) are not uncommon in the clinic and account for 10 to 20% of intracranial vascular diseases [1]. The clinical symptoms of chiasmal CMs depend on the lesion size and amount of bleeding. If the CM is large or the volume of bleeding is high, the chiasmal CM usually elicits stroke symptoms (that is, headache, vision loss and visual field defects) [3,4]. CMs involving the optic chiasm typically cause bilateral temporal visual field defects [5,6]. We describe a case with a CM located on the right side of the optic chiasm, in which the patient presented with bilateral left homonymous hemianopsia in the visual field examination. The sixmonth follow-up showed that his best-corrected visual acuity was 0.8 in both eyes, the headache had disappeared, visual field deficits were slightly improved, and no CM recurrence was found by an MRI scan. A hyperintensity in the basal ganglia was found (Figure 3)
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