Hypervascular acoustic neuroma.
The authors present a patient with a large acoustic neuroma that exhibited an unusual vascular architecture. Magnetic resonance imaging demonstrated multiple flow voids in and around the mass. At surgery, intra- and extratumoral vascularity was arterialized due to luxurious shunting. Two attempts at removal produced severe engorgement and pulsatility of the surrounding brain, dramatically narrowing the operative exposure. Piecemeal resection of the tumor seemed to redistribute blood flow resulting in engorgement of the surrounding brain, analogous to perfusion breakthrough following AVM resection. Treatment strategies similar to those used for AVM resection may be indicated when encountering a hypervascular tumor.
LeMay
D R
DR
Department of Neurosurgery, MLK/Charles Drew University, USA.
Sun
J K
JK
Fishback
D
D
Locke
G E
GE
Giannotta
S L
SL
D000328:Adult; D001165:Arteriovenous Malformations / Q000601:surgery; D001794:Blood Pressure; D002531:Cerebellum / Q000098:blood supply*; D002533:Cerebral Angiography; D002536:Cerebral Arteries; D002550:Cerebral Veins; D003390:Cranial Nerve Neoplasms / Q000098:blood supply* / Q000175:diagnosis / Q000601:surgery; D005154:Facial Nerve / Q000098:blood supply / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009389:Neovascularization, Pathologic; D009464:Neuroma, Acoustic / Q000098:blood supply* / Q000175:diagnosis / Q000601:surgery