Indocyanine green videoangiography of optic cavernous angioma

Abstract

The intraoperative findings of an indocyanine green videoangiography (ICG-VAG) study of a cavernous angioma located in the optic chiasm are reported. A 23-year-old Japanese man suddenly developed visual field loss, and magnetic resonance imaging suggested the presence of a suprasellar tumor in contact with the optic chiasm. Preoperative angiography did not clearly show any tumor shadow. Right fronto-temporal craniotomy was performed, and an aggregation of blood vessels was seen on the right surface of the optic chiasm. Cavernous angioma was suspected. ICG-VAG was begun 22 seconds after the beginning of contrast agent infusion via a peripheral blood vessel. The lesion remained unstained, although the brain surface, an artery superior to the optic nerve, and veins were visualized. The cavernous angioma was resected following surface coagulation. ICG-VAG is currently being evaluated for future application in the differential diagnosis based on imaging findings, and the present case provides an important example of intraoperative ICG-VAG imaging of an unoperated cavernous angioma.