Preoperative embolization for solid cerebellar hemangioblastoma on the day of surgery: Two case reports

Ken Kuwahara, Tomotsugu Ichikawa, Jun Haruma, Tomohito Hishikawa, Masafumi Hiramatsu, Kenji Sugiu, Isao Date

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Surgical resection of solid cerebellar hemangioblastomas can be challenging because of the profuse blood supply and tight space. We report two cases of solid cerebellar hemangioblastomas treated via surgical resection with the aid of preoperative endovascular embolization on the day of surgery. Case 1: A 36-year-old woman presented with a two-month history of headache and vomiting. Magnetic resonance imaging (MRI) revealed a right cerebellar solid mass, mild hydrocephalus, and apparent peritumoral edema. Angiogram showed a highly vascularized mass, three feeding arteries from the superior cerebellar artery (SCA), and a dilated vein draining into the confluence. We performed preoperative embolization of the three feeders with 15% n-butyl-2-cyanoacrylate (NBCA). Final angiogram showed an absence of tumor staining. Tumor resection was performed on the same day, and gross total resection was achieved with no complications. Case 2: A 36-year-old man presented with a four-month history of headache and numbness in the left upper extremity. MRI revealed a right cerebellar solid mass with peritumoral edema. Angiogram showed a highly vascularized mass with two feeding arteries from the right SCA, one from the left posterior inferior cerebellar artery (PICA), and a dilated vein draining into the confluence. Preoperative embolization was performed with 15% NBCA, and complete devascularization was achieved. Tumor resection was performed on the same day, and gross total resection was achieved with no complications. In conclusion, preoperative embolization with NBCA on the day of surgery is a safe and effective adjunctive treatment for solid cerebellar hemangioblastoma.

Original languageEnglish
Pages (from-to)615-622
Number of pages8
JournalNeurological Surgery
Volume45
Issue number7
Publication statusPublished - Jul 1 2017

Fingerprint

Hemangioblastoma
Ambulatory Surgical Procedures
Enbucrilate
Arteries
Angiography
Headache
Veins
Edema
Magnetic Resonance Imaging
Neoplasms
Hypesthesia
Hydrocephalus
Upper Extremity
Vomiting
Staining and Labeling

Keywords

  • Cerebellum
  • Preoperative embolization
  • Solid hemangioblastoma
  • Surgical risk

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Preoperative embolization for solid cerebellar hemangioblastoma on the day of surgery : Two case reports. / Kuwahara, Ken; Ichikawa, Tomotsugu; Haruma, Jun; Hishikawa, Tomohito; Hiramatsu, Masafumi; Sugiu, Kenji; Date, Isao.

In: Neurological Surgery, Vol. 45, No. 7, 01.07.2017, p. 615-622.

Research output: Contribution to journalArticle

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