ENDOVASCULAR PRELUDE FOR DELICATE MENINGEOMA OPERATION: A CASE REPORT
Introduction: Embolization prior to surgery can make tumor resection less complicated by reducing blood loss during surgery and shortening the time of the operation.
Case report: In this paper, we presented a case of a sixty-three-year-old woman who was admitted to the Clinic of Neurosurgery, Clinical Center Ni, Serbia, at November 2016, after she underwent a CT brain scan that showed a large tumor of the left cerebellopontile angle. Digital subtraction angiography presented a large, highly vascularized tumor lesion that compressed the brain stem. The patient underwent endovascular procedure, and complete embolization of the tumor vessels was established. The radiologist delivered embolization material via the left ascending pharyngeal artery. In the next 24 hours, an operation was performed i.e. radical extirpation surgery (Simpson grade I). Postoperatively, the patients GCS was 15, with no new neurological deficit. Postoperative brain CT scan showed neither rest tumor nor blood clot inside the tumor bed. Pathohistological finding revealed atypical meningioma grade II.
Conslusion: Despite some clinicians dilemma considering the utility of preoperative embolization of meningioma vessels, we believe that a team of educated and dedicated radiologist and neurosurgeon could achieve great results in resection of large and inaccessible cranial tumors.
Lazzaro MA, Badruddin A, Zaidat OZ, Darkhabani Z, Pandya DJ, Lynch JR. Endovascular embolization of head and neck tumors. Front Neurol. 2011; 2: 64.
Becker H. Complication following embolization of a meningioma. Clin Neuroradiol. 2010; 20(4):237-41.
Shimoda Y, Osanai T, Terasaka S, Kobayashi H, Yamaguchi S, Endo S, et al. Efficiency of embosphere in the preoperative embolization of meningioma: clinical experience No Shinkei Geka. 2016; 44(7):555-60.
He HW, Jiang CH, Wu ZX, Li YX, Lü XL, Wang ZC. Transvenous embolization with a combination of detachable coils and Onyx for a complicated cavernous dural arteriovenous fistula. Chin Med J (Engl). 2008;121(17):1651-5.
Minakawa T, Koike T, Tanaka R, Ito J. Disappearance of a tumor shadow fed by the tentorial artery after embolization of the external carotid artery. Surg Neurol. 1987; 28(3):208-10.
Singla A, Deshaies EM, Melnyk V, Toshkezi G, Swarnkar A, Choi H, et al. Controversies in the role of preoperative embolization in meningioma management. Neurosurg Focus. 2013; 35(6):E17.
Richter HP, Schachenmayr W. Preoperative embolization of intracranial meningiomas Neurosurgery 1983; 13(3):261-8.
Berenstein A, Kricheff II. Catheter and material selection for transarterial embolization: technical considerations. II. Materials. Radiology. 1979;132(3):631–9.
Gruber A, Killer M, Mazal P, Bavinzski G, Richling B. Preoperative embolization of intracranial meningiomas: a 17-years single center experience. Minim Invasive Neurosurg. 2000;43(1):18-29.
Kusaka N, Tamiya T, Sugiu K, Tokunaga K, Nishiguchi M, Takayama K, et al. Combined use of TruFill DCS detachable coil system and Guglielmi detachable coil for embolization of meningioma fed by branches of the cavernous internal carotid artery. Neurol Med Chir (Tokyo). 2007; 47(1):29-31.
Esquembre V, Cabanes J, Vazquez-Añón V, Chirivella M, Giner R, Gutiérrez A, et al . Preoperative embolization of a ponto-cerebellar meningioma. Advantages and indications. Neurocirugía.2001;12(4): 342–7.
Felbaum DR, Mueller K, Liu AH, Armonda RA. Onyx embolization of a meningioma with a dysplastic aneurysmal anterior cerebral artery vessel. Cureus. 2016;11;8(9):e776.
Shah A, Choudhri O, Jung H, Li G. Preoperative endovascular embolization of meningiomas: update on therapeutic options. Neurosurg Focus. 2015;38(3):E7.
Fang QR, He XY, Li XF, Zhang X, Chen M, Li H, et al. Comparative efficacy of Glubran and polyvinyl-alcohol particles in the embolization of meningiomas. Int J Neurosci. 2016;126(12):1112-9.
Jo K, Park HJ, Nam DH, Lee JI, Kong DS, Park K, et al. Treatment of atypical meningioma. J Clin Neurosci. 2010; 17(11):1362-6.
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