Hemorrhage after particle embolization of hemangioblastomas: comparison of outcomes in spinal and cerebellar lesions

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Object

In this study the authors compare the clinical outcomes after particle embolization of hemangioblastomas in the cerebellum and spinal cord. They also review the literature of similar cases.

Methods

Seven patients with hemangioblastomas in the spinal cord (four patients) and cerebellum (three patients) underwent preoperative embolization at the authors' center. Magnetic resonance imaging and selective angiography studies as well as histological diagnoses were available in all patients. Embosphere particles (trisacryl gelatin microspheres) were used in all cases. The smallest particle diameter ranged from 100 to 300 μm at the beginning of embolization in all patients.

The outcome of embolization was favorable in patients with spinal cord hemangioblastomas, but it was unfavorable for those with cerebellar hemangioblastomas; acute tumor bleeding and death occurred in all of the latter cases. The outcomes following embolization are very different for these two locations possibly because of the different capillary sizes.

Conclusions

The authors no longer use particle embolization to treat cerebellar hemangioblastomas.

Abbreviations used in this paper:ASA = anterior spinal artery; CPA = cerebellopontine angle; CT = computed tomography; EVD = external ventricular drain; MMA = middle meningeal artery; MR = magnetic resonance; NBCA = N-butyl-cyanoacrylate; PICA = posteroinferior cerebellar artery; PVA = polyvinyl alcohol; VA = vertebral artery.

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Contributor Notes

Address reprint requests to: Emmanuel Houdart, M.D., Department of Neuroradiology, Lariboisière Hospital, 2 rue Ambroise Paré, 75010 Paris, France. email: emmanuel.houdart@lrb.ap-hop-paris.fr.
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