• AlejandroSebastián AníbalSADepartment of Neurosurgery, Universidade Federal de Sao Paulo, São Paulo-SP, Brazil., Juan Leonardo Serrato-Avila, Samantha Lorena Paganelli, José Ernesto Chang Mulato, Evelyn Judith Vela Rojas, Ana Paula Viera Neves, Daniela de Souza Coelho, Silva da CostaMarcos DevanirMDDepartment of Neurosurgery, Universidade Federal de Sao Paulo, São Paulo-SP, Brazil., Hugo Leonardo Dória-Netto, Campos FilhoJosé MariaJMDepartment of Neurosurgery, Universidade Federal de Sao Paulo, São Paulo-SP, Brazil; Hospital Beneficência Portuguesa de São Paulo, São Paulo-SP, Brazil., and Feres Chaddad-Neto.
• Department of Neurosurgery, Universidade Federal de Sao Paulo, São Paulo-SP, Brazil.
• World Neurosurg. 2022 Jan 1; 157: 159.

AbstractCavernous malformations (CM) affect approximately 0.5% of the population, with only a limited portion being located in the optic nerve and chiasma. The clinical presentation is determined by their locations. In the optochiasmatic CM, the acute visual disturbance is the most common presentation. Chronically, many show a progressive visual loss, chronic headache, and pituitary disturbances. The differential diagnosis includes optic glioma, arteriovenous malformations, aneurysm, craniopharyngioma, pituitary apoplexy, and inflammatory conditions. In Video 1, we present the case of a 39-year-old woman with a history of a hemorrhagic optochiasmatic cavernoma in 2016, who started using propranolol to reduce the lesion and symptoms of visual loss. Moreover, the first microsurgical resection of the cavernoma and evacuation of the hematoma were performed in the same year. Owing to evolvement from a partial to a total vision loss in the left eye and presentation of new symptoms in the right eye, the patient underwent microsurgical resection. The surgery was performed sequentially. An awake craniotomy was performed to monitor the chiasma and right optic nerve. The postoperative magnetic resonance imaging showed complete resection of the CM, and the patient fully recovered. The patient signed the institutional consent form, stating that he or she accepts the procedure and allows the use of his or her images and videos for any type of medical publications in conferences and/or scientific articles.Copyright © 2021 Elsevier Inc. All rights reserved.

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