Hemorrhage after particle embolization of hemangioblastomas: comparison of outcomes in spinal and cerebellar lesions

Cornelius, Jan Frédérick; Saint-Maurice, J.-P.; Bresson, D.; George, Bernard; Houdart, Emmanuel

doi:10.3171/jns.2007.106.6.994

Cited by 83 publications

(64 citation statements)

References 15 publications

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“…Several available published data also showed that preoperative embolization was a safe and effective adjuvant therapy (Djindjian, 1986;Standard et al, 1994;Krishnan et al, 2006;Cornelius et al, 2007;Agrawal et al, 2010). However, the reports of preoperative embolization of CHB are still relatively rare, and most of them were individual case reports.…”

Section: Introductionmentioning

confidence: 99%

“…A large comparative study of the CHB surgical treatment with and without preoperative embolization remains lacking. Therefore, to the extent that we know, the safety and effectiveness of preoperative embolization in CHB treatment has yet to be confirmed (Standard et al, 1994;Krishnan et al, 2006;Cornelius et al, 2007). A study that compares surgical time, intraoperative blood loss and blood transfusion, clinical efficacy and incidence of complications between patients underwent surgical resection with and without preoperative embolization is essential to evaluate the risk and benefits of preoperative embolization in the surgical treatment of CHB.…”

Section: Introductionmentioning

confidence: 99%

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Clinical Effectiveness of Preoperative Embolization for Cerebellar Hemangioblastoma

Liu

Peng²,

Wu³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical Effectiveness of Preoperative Embolization for Cerebellar Hemangioblastoma

Liu

Peng²,

Wu³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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“…Cornelius et al 24 summarized several studies on preoperative embolization and reported an embolization-related complication rate of 5.6% in patients with spinal hemangioblastomas. Shi et al 86 reported no complications after embolization in 18 cases of vascular spinal tumors.…”

Section: 43mentioning

confidence: 99%

“…24,32,77 Spinal cord ischemia due to inadvertent vessel embolization of unrecognized radiculomedullary arteries is a devastating possible complication. 48,72 Other reported complications have included pain, and subarachnoid, peritumoral hemorrhage.…”

Section: Procedure-related Complicationsmentioning

confidence: 99%

“…52 Although endovascular embolization can reduce intraoperative blood loss, it is for the most part not routinely performed, as complications were previously reported, including spinal cord swelling, massive venous bleeding, intratumoral hemorrhage, and spinal cord ischemia. 24,29,34,40 Temporary arterial occlusion (TAO) by aneurysm clip placement with concurrent neuromonitoring is a microsurgical technique that helps to differentiate the arteries supplying the tumor from those supplying the healthy spinal cord. 23 To our knowledge, no randomized studies exist comparing the resection of nonmetastatic vascular intraspinal tumors with or without preoperative embolization.…”

Section: Neurosurgical Management Of Vascular Intraspinal Tumorsmentioning

confidence: 99%

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Imaging diagnosis and the role of endovascular embolization treatment for vascular intraspinal tumors

Santos

Zhang

Ghinda

et al. 2015

FOC

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Intraspinal tumors comprise a large spectrum of neoplasms, including hemangioblastomas, paragangliomas, and meningiomas. These tumors have several common characteristic imaging features, such as highly vascular mass appearance in angiography, hypointense rim and serpentine flow voids in MRI, and intense enhancement after intravenous contrast administration. Due to their rich vascularity, these tumors represent a special challenge for surgical treatment. More recently, the surgical treatment of intraspinal vascular tumors has benefited from the combination of endovascular techniques used to better delineate these lesions and to promote preoperative reduction of volume and tissue blood flow. Endovascular embolization has been proven to be a safe procedure that facilitates the resection of these tumors; hence, it has been proposed as part of the standard of care in their management.

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Review of the Neurological Implications of von Hippel–Lindau Disease

et al. 2018

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on Hippel-Lindau (VHL) disease is an autosomal dominant neoplasia syndrome caused by a germline mutation of the VHL tumor suppressor gene (NC_000003.12) located on the short arm of chromosome 3. [1][2][3] This disease carries a prevalence of 1 in 36 000 births 4 and is highly penetrant (>90% penetrance by age 65 years). 3 Patients with VHL disease can develop lesions of the viscera and central nervous system (CNS). Visceral lesions include renal cell carcinomas or cysts, pheochromocytomas, pancreatic neuroendocrine tumors or cysts, and benign cystadenomas of the adnexal organs. The CNS-associated lesions include hemangioblastomas of the retina and craniospinal axis as well as endolymphatic sac tumors (ELSTs). [4][5][6] The most frequent cause of VHL diseaseassociated morbidity and mortality is craniospinal hemangioblastoma development and progression. 7 IMPORTANCE von Hippel-Lindau (VHL) disease-associated central nervous system (CNS) lesions include hemangioblastomas and endolymphatic sac tumors (ELSTs), which are associated with significant neurological morbidity and mortality. Recent studies provide critical new biological, diagnostic, and management insights into these tumors.OBSERVATIONS Biological features, natural history, clinical findings, and management strategies of VHL disease-associated CNS tumors are reviewed. The VHL disease results from a germline mutation of the VHL gene (located on the short arm of chromosome 3), a tumor suppressor that encodes for the VHL protein. Whereas VHL disease is associated with visceral manifestations, CNS lesions are the most common source of morbidity and mortality. Craniospinal hemangioblastomas are almost entirely (99%) found in the cerebellum, brainstem, and spinal cord. These tumors arise from multipotent hemangioblasts. Peritumoral cysts frequently underlie the clinical findings associated with hemangioblastomas (>90% of symptomatic tumors). Prospective natural history studies demonstrate that CNS hemangioblastomas typically grow in a saltatory pattern. Due to this unpredictable growth pattern, surgical resection is reserved for symptomatic lesions, as many tumors do not become symptomatic. Recent studies indicate that VHL disease-associated ELSTs cause audiovestibular morbidity (hearing loss, tinnitus, and vertigo) via 3 mechanisms-otic capsule invasion, intralabyrinthine hemorrhage, and endolymphatic hydrops. Specialized magnetic resonance imaging techniques have been defined to elucidate each of these mechanisms, even when a tumor mass is not identified on imaging. Endolymphatic sac tumors cause audiovestibular morbidity unrelated to size or progression, and resection is now recommended at initial discovery of a tumor mass or a tumor-associated mechanism of morbidity.CONCLUSIONS AND RELEVANCE New insights into the development, pathobiological origin, natural history, and long-term outcomes of VHL disease-associated CNS tumors have redefined their management and treatment indications and potentially provide new targeted therapeutic strategies. Resection is rese...

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Hemorrhage after particle embolization of hemangioblastomas: comparison of outcomes in spinal and cerebellar lesions

Abstract: The authors no longer use particle embolization to treat cerebellar hemangioblastomas.

Cited by 83 publications

References 15 publications

Clinical Effectiveness of Preoperative Embolization for Cerebellar Hemangioblastoma

Clinical Effectiveness of Preoperative Embolization for Cerebellar Hemangioblastoma

Imaging diagnosis and the role of endovascular embolization treatment for vascular intraspinal tumors

Review of the Neurological Implications of von Hippel–Lindau Disease

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