J Cerebrovasc Endovasc Neurosurg.  2024 Sep;26(3):304-310. 10.7461/jcen.2024.E2023.04.006.

Giant cerebellar cavernous malformation in children: A case report and literature review

• Akramov OZ
• Nazarova LA
• Kurbanov FM
• Tashmatov SA
• Rakhimov II
• Usmankhanov OA
• Chaurasia B

• KMID: 2559441
• DOI: http://doi.org/10.7461/jcen.2024.E2023.04.006

Abstract

Giant cerebellar cavernomas in children are rare and must be differentiated from hemorrhagic cerebellar tumors. The diagnosis and treatment of giant cerebellar cavernomas is challenging, but complete surgical resection can lead to favorable outcomes and complete neurological recovery in most cases. We present a case of eight months old baby who was diagnosed with a giant cavernoma resulting in secondary obstructive hydrocephalus with neuropsychiatric presentations. The patient underwent a paramedian craniotomy surgery with a suboccipital approach and complete surgical resection of the cavernoma was done. Over nine months of observation, the child showed improvement in their ability to walk and fully recovered from a neurological perspective. We also conducted a literature review to identify eleven cases of giant cerebellar cavernomas in children, including our case. The data were analyzed to determine the clinical features, treatment, and outcomes of giant cerebellar cavernomas in children.

Keyword

Cerebral cavernous malformation; Cerebellum; Central nervous system vascular malformations

Figure

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  Fig. 1. MRI of brain T2 FLAIR axial section (A) showed the lesion was 56×54×64 mm.The structure was heterogeneous and the intensity of the area was predominantly heterogeneous. MRI showed signs of a cystic-solid formation with multiple cyst-like inclusions with a horizontal level in the projection of the right hemisphere of the cerebellum and its vermis, ventriculomegaly, and moderate atrophy of the cerebral cortex in both frontotemporal regions. (B) T2 weighted coronal. (C) T1 FLAIR sagittal image showing multiple cystic lesions with fluid level. (D) T1 FLAIR enlargement of lateral and third ventricles with periventricular edema. MRI, magnetic resonance imaging; FLAIR, fluid attenuated inversion recovery

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  Fig. 2. Histopathology image: Hematoxylin and eosin staining (10×) demonstrating large, endothelial-lined, capillary-type vessels of various sizes with evidence of erythrocyte breakdown.

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  Fig. 3. Postoperative images showing complete removal of the lesion. (A) T2 axial MRI, (B) T2 FLAIR axial MRI, (C) T2 weighted coronal sections displaying the bed of the removed cavernoma, (D) T2 axial section demonstrating regression of expansion of cerebral ventricles. MRI, magnetic resonance imaging; FLAIR, fluid attenuated inversion recovery

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