Long-term results in a case of meningioma treated by embolization alone--case report

A 73-year-old female, unable to walk without a cane, was hospitalized for evaluation of left sensorimotor disturbance. Computed tomographic (CT) scans revealed a large parasagittal mass, which was markedly and homogeneously enhanced by contrast material. Bilateral external carotid angiograms showed that the middle meningeal arteries supplied the tumor. Both CT and angiographic findings suggested a right frontal parasagittal meningioma. Catheter embolization with Ivalon (polyvinyl alcohol foam) particles was carried out prior to the planned surgery for the purpose of decreasing intraoperative hemorrhage from the tumor. However, her clinical symptoms began to improve 9 days after the embolization procedure, and surgery was decided against because of her advanced age and symptomatic improvement. Ten months after embolization, she was able to walk unassisted and CT scans showed a 60% reduction of the pre-embolization tumor size. Four years after embolization, she remained nearly asymptomatic despite some regrowth of the tumor.