gms | German Medical Science

60th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Benelux countries and Bulgaria

German Society of Neurosurgery (DGNC)

24 - 27 May 2009, Münster

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Deep vascular orbital lesions

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  • U. Schick - Neurochirurgische Klinik, Universitätsklinikum Heidelberg
  • W. Hassler - Neurochirurgische Klinik, Wedau Kliniken Duisburg

Deutsche Gesellschaft für Neurochirurgie. 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien. Münster, 24.-27.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. DocDI.06-04

doi: 10.3205/09dgnc147, urn:nbn:de:0183-09dgnc1470

Published: May 20, 2009

© 2009 Schick et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: There are rare descriptions of vascular orbital malformations. We present the haemodynamics and endovascular and/or surgical treatment of deep vascular orbital lesions.

Methods: We report on our series of 58 vascular lesions of the orbit treated between 1991 and 2008.

Results: We distinguish between three types of haemodynamics. Most common are arteriovenous malformations characterized by direct low flow such as cavernous haemangiomas (n=44), treated by complete excision. Capillary haemangiomas (n=1) undergo spontaneous regression. Surgery is appropriate in well-circumscribed lesions. Direct anterograde high flow lesions like AVMs are rare (n=4), undergoing an endovascular and/ or surgical treatment. Venous flow lesions appear as distensible lesion (n=3) with rich communication or non-distensible anomalies (n=4). Deep venous lesions (n=7) should be treated if they cause severe pain, cosmetic disturbances or visual deterioration.

No flow lesions have little connection to the vascular system and include lymphangiomas (n=2). Surgery may be helpful in distinct cases with intracystic haemorrhage.

Conclusions: The haemodynamic and clinical presentation of the vascular lesion determine the recommended treatment. Generally, we favour early treatment after the onset of symptoms.