Giant Extra-Axial Cavernous Angioma of the Falx: Case Report

BACKGROUND AND IMPORTANCE: Cavernous angiomas or cavernomas are vascular malformations usually located in the brain parenchyma. However, they rarely present as extra-axial lesions, attached to the dura, and may mimic meningiomas. Most reported cases concern the cavernous sinus region and other locations are very uncommon. CLINICAL PRESENTATION: A 61-yr-old female known for long-standing mental illness presented with progressive gait instability. Imaging studies revealed an extra-axial lesion in relation to the anterior part of the falx cerebri. An interhemispheric approach was used to remove the lesion. Pathological analysis revealed features compatible with an extra-axial cavernoma: structureless vascular channels lacking smooth muscle and elastic lamellae, without intervening brain parenchyma. CONCLUSION: Cavernous angiomas or cavernomas can present as extra-axial lesions. Although progressive growth can be observed, they should not be considered as tumoral lesions, because there is no cellular duplication. Unlike other locations, resection of anterior cranial fossa extra-axial cavernomas seems to be facilitated by minimal bleeding.