대후두공 주변에 발생한 경막내 축외 해면상 혈관종

An Intradural and Extra-axial Cavernous Hemangioma on Foramen Magnum

Intraparenchymal cavernous hemangioma(CH) of central nervous system(CNS) was already well known to us, but the intradural and extra-axial CH was not and very rare. This case summarizes our surgical experience intradural-extramedullary CH on foramen magnum. A 44-year-old man complained occipital headache. Magnetic resonance imaging(MRI) showed a 15mm sized well enhancing mass that slightly displaced the medulla to the right side. An angiogram showed tumor staining with feeding artery from left posterior cerebellar artery(PICA). Our diagnosis with imaging studies was extra-axial tumor including meningioma, hemangiopericytoma. A suboccipital craniectomy and C1 laminectomy were performed. An encapsulated, highly vasculized mass was visualized and removed. Mass was purely extra-axial and pathological evaluation demonstrated a CH. So this case of CH reminds the neurosurgical community to consider CH in the differential diagnosis for extra-axial mass on foramen magnum.