Preoperative embolization of solid cervicomedullary junction hemangioblastomas: report of two cases

Abstract

Solid cervicomedullary haemangioblastomas represent a small but technically challenging subset of posterior fossa haemangioblastomas because of their site, high vascularity and tendency to bleed. We present our experience with preoperative embolisation of two solid cervicomedullary haemangioblastomas. In both cases the main feeding artery was the posterior inferior cerebellar artery. Arterial pedicles were catheterised with a microcatheter. The embolic material was small particles (150-250 microm) of polyvinyl alcohol. The result was almost complete preoperative obliteration of the vessels of the tumours. The procedure was well tolerated and facilitated easier bloodless, successful resection in both cases, 24 h after embolisation.

The Role of Stereotactic Radiosurgery for Intracranial Hemangioblastomas

“…The highly vascular nature of some hemangioblastomas may benefit from preoperative embolization before surgical removal (6,18,19). Complete surgical resection is often curative, whereas subtotal resection results in predictable recurrences (14).…”

Neuroprotective Role of Neurophysiological Monitoring During Endovascular Procedures in the Spinal Cord

“…Endovascular techniques are increasingly used in the treatment of hypervascularized lesions in the spinal cord and surrounding structures. Devascularization of spinal cord tumors, obliteration of intramedullary arteriovenous malformations, and occlusion of spinal or dural fistulas1–6 can be achieved by injecting embolizing materials through a catheter selectively introduced into the vessels feeding the lesion. These procedures, however, put the spinal cord at risk for ischemia, which is mostly related to vasospasm or unrecognized obliteration of vessels feeding the normal spinal cord.…”

Predominantly Solid Hemangioblastoma Presenting as an Extra-Axial Cerebellopontine Angle Lesion

“…Furthermore, preoperative radiosurgery has shown to reduce the vascularity and control bleeding of this hypervascular neoplasm prior to resection [14]. Such an approach allows complete surgical resection with acceptable morbidity [15]. Although the optimal timing of surgery is uncertain, the consensus is initial MRI evaluation.…”