Pre-Operative Endovascular Embolization of a Cerebellar Haemangioblastoma

A. Abo-Al Hassan, M. Ismail, S.M. Panda
2006 Medical Principles and Practice  
2.5% of all intracranial tumours. HBs may occur sporadically as isolated tumours of the cerebellum or may represent a familial disorder as part of the von Hippel-Lindau (VHL) complex [1] . HBs can be difficult to resect owing to its hypervascularity and location in the posterior fossa [2] . High rates of morbidity and mortality are associated with uncontrollable intra-operative haemorrhage [3] . We report a case of pre-operative embolization of a cerebellar HB. Case Report A 36-year-old male
more » ... sented with several months' history of gradual and progressive headache, mainly in the right occipital region. There was a positive family history of VHL syndrome. On clinical examination, there was a slight nystagmus to the left side. No associated cerebellar symptom, visual disturbance or other neurological symptoms were observed. The patient underwent brain MRI, which revealed a 3 ! 3 cm right cerebellar solid mass, hyperintense on a T 2 -weighted image and hypo-intense on a T 1weighted image, with thick irregular peripheral enhancement after intravenous gadolinium injection ( fig. 1 ). Following MRI, the patient underwent diagnostic cerebral angiography, which showed a hypervascular mass in the inferior aspect of the right hemisphere with a large arterial feeder arising from the right anterior inferior cerebellar artery (AICA), and a smaller feeder from the right posterior inferior cerebellar artery ( fig. 2 ). This was followed by pre-operative embolization of the tumour's vascular bed on the day prior to surgery. The embolization proce- Abstract Objective: To present an interesting case of pre-operative embolization of a cerebellar haemangioblastoma. Clinical Presentation and Intervention: A 36-year-old male presented with gradual, progressive headache and a positive family history of von Hippel-Lindau syndrome. MRI of the brain revealed a right cerebellar solid mass and cerebral angiography demonstrated its extensive hypervascular nature. The mass was embolized with polyvinyl alcohol prior to surgical resection, which resulted in improvement of the patient's symptoms. Conclusion: Pre-operative embolization of a haemangioblastoma is a useful procedure that can potentially decrease the morbidity and mortality of its surgical resection.
doi:10.1159/000095495 pmid:17047356 fatcat:2ak7rltgcrgnthhc2x5e3rjumq