Optic-Chiasmatic Cavernoma: Catastrophic Presentation of a Rare Suprasellar Vascular Malformation - a Case Report

The aim of this study is to report a rare case of an optic-chiasmatic cavernoma, an uncommon intracranial vascular malformation that accounts for less than 1% of all cavernoma cases. We present the case of a 43-year-old female patient with progressive visual loss in the left eye, associated with frontotemporal headache, diagnosed through magnetic resonance imaging (MRI). MRI revealed an expansive lesion involving the left optic chiasm and hypothalamus, with signs of recent hemorrhage and mass effect. The patient also presented with a left infraputaminal parenchymal hematoma and subarachnoid hemorrhage. She underwent immediate surgical treatment, and histopathological analysis confirmed the diagnosis of cavernoma. MRI showed typical features of cavernous malformation, including lobulated heterogeneous lesions with mixed hypo- and hyperintense signals on T1- and T2-weighted sequences, associated with hemoglobin degradation products. The patient experienced total vision loss in the left eye and partial loss in the right eye. MRI proved essential for early diagnosis and effective treatment of the condition. This case highlights the critical role of MRI in diagnosis and the potential for surgical intervention to improve patient outcomes.