Role of preoperative embolization of intramedullary hemangioblastoma.

Details

Serval ID
serval:BIB_9C5C8BD6B511
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Title
Role of preoperative embolization of intramedullary hemangioblastoma.
Journal
Neuro-Chirurgie
Author(s)
Saliou G., Giammattei L., Ozanne A., Messerer M.
ISSN
1773-0619 (Electronic)
ISSN-L
0028-3770
Publication state
Published
Issued date
11/2017
Peer-reviewed
Oui
Volume
63
Number
5
Pages
372-375
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
Hemangiobastomas (HB) are rare lesions accounting for 1 to 5% of all spinal cord tumors. Due to their hypervascular nature, an angiography may be proposed preoperatively in order to identify tumoral vascular anatomy. Preoperative embolization may be indicated to reduce intraoperative bleeding, thus facilitating tumor resection and minimizing surgical risk. The aim of this paper is to report our experience of preoperative embolization in intramedullary hemangioblastomas.
We performed a retrospective analysis of all patients operated on for intramedullary hemangioblastomas between 1995 and 2014 who had undergone embolization before surgery.
Seven patients were analyzed: there were 6 females and 1 male, mean age 43years, 6 patients had Von Hippel-Lindau disease. Four tumors were located in the cervical spine and three in the dorsal spine. The average maximum sagittal diameter was 19mm (range 8-32mm), while the average maximum axial diameter was 11.5mm (range 6-21mm). The embolic agent used was Histoacryl (NBCA). Endovascular embolization was routinely performed the day before surgery. One patient experienced a major preoperative complication with a vertebrobasilar infarctus with consequent unilateral cerebellar syndrome and gait instability. Minor extravasation of embolic agent was observed in two cases. In one of these two cases, there was also the penetration of the embolic agent in the tumor; the resection was impossible due to the hard consistency of the tumor. In the other 6 patients, the resection was total. Six patients had identical preoperative and postoperative McCormick score and one patient shifted to a better score at follow-up.
Preoperative endovascular embolization is an effective adjunct treatment. It is useful in reducing the surgical bleeding and thus the operative risks. The procedure is not always safe and complications could occur. We recommend preoperative embolization in selected cases.

Keywords
Embolization, Hemangioblastomas, Spinal cord tumor
Pubmed
Create date
20/01/2017 15:30
Last modification date
20/08/2019 15:03
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