Intracranial cavernous sinus cavernous hemangioma is an extremely rare type of cavernous hemangioma. Americans call cavernous sinus cavernous hemangioma (English: hemangioma in the cavernous sinus or cavernous sinus hemangioma). In the neurosurgery department of Huashan Hospital, there are 10,000 brain surgeries per year and about 10-13 cases of cavernous sinus hemangioma, which accounts for 0.1-0.13% of brain tumors. Therefore this tumor is extremely rare, but it is more common in Asians than in Europeans and Americans. Some scholars refer to cavernous hemangioma as cavernous vascular malformation, but most scholars currently treat cavernous sinus cavernous hemangioma as a vascular tumor. The cavernous hemangiomas near the spongy sinus, middle skull base, and orbit are histopathologically identical to those in the brain parenchyma, but the two grow in completely different ways. Cavernous hemangiomas in the spongy sinus, middle skull base, and near the orbit (outside of the brain parenchyma) (outside of the intracranial brain parenchyma) are most often seen in female patients. The tumors grow slowly and are asymptomatic in the early stages. When clinical symptoms are present, most tumors are relatively large or even massive. Before the advent of Gamma Knife and Radiofrequency Knife, most patients opted for surgical removal of the tumor and very few patients received conventional radiotherapy. Small and medium-sized cavernous sinus cavernous hemangiomas can be treated directly with Gamma Knife and also with Radio Wave Knife. Since the introduction of the radiofrequency knife at Huashan Hospital in December 2007, we have treated a total of nearly 50 cases of cavernous sinus cavernous hemangioma with the radiofrequency knife, all with very good results. Most of the cavernous sinus cavernous hemangiomas treated with the radio wave knife are large tumors and giant tumors. By irradiating the tumor in fractions, the radio wave knife allows the tumor to receive a higher treatment dose while increasing the dose of radiation tolerated by the cranial nerves (optic nerve, motor nerve, trigeminal nerve, abducens nerve and talocrural nerve) (i.e.: reducing or decreasing the damage to the cranial nerves). By following up with each patient, the results of the radiofrequency knife treatment were found to be excellent. Most of the neurosurgeons at Huashan Hospital are able to correctly diagnose cavernous sinus cavernous hemangioma by looking at magnetic resonance imaging (MRI) films of the brain. Once they diagnose a cavernous sinus cavernous hemangioma, they will recommend the patient to be treated with the radio wave knife. A meta-analysis of radiosurgery (Gamma Knife, X Knife) for cavernous sinus cavernous hemangioma by Dr. Xin Wang of our department concluded that radiosurgery is effective and has mild side effects in treating cavernous sinus cavernous hemangioma (paper published in the foreign journal of neuro-oncology, J Neurooncology). The radiofrequency knife has treated nearly 50 such patients in just 4 years, and after treatment the tumors shrank, some of them almost disappeared, and the patients’ vision improved. These good results and the good outcome with almost no post-treatment side effects confirm the superiority of radio wave knife treatment, which will gradually become the main tool for the treatment of cavernous sinus cavernous hemangioma or even replace surgery completely when weighing the risks of surgery and post-surgical complications. Unfortunately, a significant number of neurosurgeons do not recognize cavernous sinus cavernous hemangioma, and a significant number of neurosurgeons are simply unaware of the extremely good results of the radiofrequency knife in treating this type of tumor. I hope this article will be seen by more patients and their families to reduce the suffering of such patients due to surgery. Here are a few cases, before and after treatment with the radio wave knife. Case 1: The patient had a headache and a huge tumor. According to the opinion of brain surgery specialists, this tumor must need to be removed surgically, but after I looked at the patient’s magnetic resonance imaging (MRI) images, I diagnosed it as a cavernous sinus cavernous hemangioma. I definitely told the patient and his family that radio wave knife fractionated treatment can replace surgery and the treatment effect is very good. Case 2 was also a huge cavernous sinus cavernous hemangioma, and we irradiated the tumor in three sessions. The patient recovered well after treatment, but the patient was a rural patient and did not want to review the MRI. Two years after the treatment, I paid for her MRI review, and the results of the review confirmed the effectiveness of our treatment, and the tumor shrunk by more than 90%.