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 language | English |
|---|---|
| Pages (from-to) | 615-622 |
| Number of pages | 8 |
| Journal | Neurological Surgery |
| Volume | 45 |
| Issue number | 7 |
| Publication status | Published - Jul 1 2017 |
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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 journal › Article
}
TY - JOUR
T1 - Preoperative embolization for solid cerebellar hemangioblastoma on the day of surgery
T2 - Two case reports
AU - Kuwahara, Ken
AU - Ichikawa, Tomotsugu
AU - Haruma, Jun
AU - Hishikawa, Tomohito
AU - Hiramatsu, Masafumi
AU - Sugiu, Kenji
AU - Date, Isao
PY - 2017/7/1
Y1 - 2017/7/1
N2 - 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.
AB - 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.
KW - Cerebellum
KW - Preoperative embolization
KW - Solid hemangioblastoma
KW - Surgical risk
UR - http://www.scopus.com/inward/record.url?scp=85029312466&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85029312466&partnerID=8YFLogxK
M3 - Article
AN - SCOPUS:85029312466
VL - 45
SP - 615
EP - 622
JO - Neurological Surgery
JF - Neurological Surgery
SN - 0301-2603
IS - 7
ER -