Preoperative embolization of upper cervical cord hemangioblastoma concomitant with venous congestion--case report.
A 16-year-old male presented with a large, solid hemangioblastoma located in the upper cervical cord manifesting as hyperactive reflexes, subtle weakness, and diminished position sense in all extremities. Neuroimaging studies indicated venous congestion due to arteriovenous shunt through the tumor. Preoperative embolization was accomplished without morbidity, and resulted in marked devascularization of the tumor and elimination of an early filling vein. Four days after embolization, the tumor was totally excised without excessive intraoperative bleeding. His neurological deficits gradually improved after surgery. Preoperative embolization is a valuable adjunct to surgical excision of large intramedullary hemangioblastomas, especially those associated with arteriovenous shunt, as cord dysfunction related to venous congestion and the risk of torrential intraoperative bleeding are reduced.
Ohtakara
K
K
Department of Neurosurgery, Mie University School of Medicine, Tsu, Japan.
Kuga
Y
Y
Murao
K
K
Kojima
T
T
Taki
W
W
Waga
S
S
D000293:Adolescent; D002574:Cervical Vertebrae; D003131:Combined Modality Therapy; D004621:Embolization, Therapeutic / Q000379:methods; D018325:Hemangioblastoma / Q000098:blood supply* / Q000175:diagnosis / Q000601:surgery / Q000628:therapy*; D006801:Humans; D008297:Male; D019635:Neurosurgical Procedures; D011300:Preoperative Care / Q000379:methods; D020127:Recovery of Function; D013120:Spinal Cord Neoplasms / Q000098:blood supply* / Q000175:diagnosis / Q000601:surgery / Q000628:therapy*; D016896:Treatment Outcome