1983 Volume 23 Issue 4 Pages 305-310
The authors presented a surgically treated case of cavernous hemangioma on the fourth ventricle floor.
The patient was a 44-year-old female who complained of double vision. Neurological examination revealed left facial nerve palsy, bilateral internuclear ophthalmoplegia, and hypesthesia of the right trigeminal area. Vertebral angiography did not show any sign of space taking lesion or of vascular abnormality. CT scan 1 week after onset of symptoms showed a round, high density area on the fourth ventricle floor and a perifocal low density area. The patient was followed and a CT scan was performed every 5 months. Although the neurological signs disappeared within 6 months, a CT scan after 15 months revealed a persistent high density area with minimal contrast enhancement. A pneumoencephalotomogram clearly visualized a semi globular filling defect 1 cm in diameter protruding into the fourth ventricle. At surgery, a red mulberry-like tumor was found in the middle of the fourth ventricle floor. Gliosis and hemosiderosis were seen at the base of the tumor. The tumor was totally resected. Microscopic examination showed closely packed, thin-walled vascular channels lined by a single layer of endothelial cells. The histological diagnosis was cavernous hemangioma. Three such previously reported cases are summarized.
