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Comprehensive Endovascular and Open Surgical Management of Cerebral Arteriovenous Malformations
Published on: October 20, 2017
[Endovascular management of skull base tumors. A practical review on literature]
Luis Rafael Moscote-Salazar1, Jorge Balderrama, Hernando Raphael Alvis-Miranda
1Servicio de Neurocirugía, Universidad de Cartagena, Cartagena, Colombia. mineurocirujano@aol.com.
Abstract:
Generally speaking, skull base tumors are very difficult-to-reach lesions. More or less, two thirds of those tumors correspond to meningiomas, which are highly vascular tumors. Tumors that are able to an embolization are juvenile nasopharyngeal angiofibromas, hemangiopericytomas, hemangioblastomas, meningiomas, metastatic lesions, paragangliomas, glomus tumors and other paragangliomas. Pre-operatory embolization of tumors arising in the skull base is a surgical strategy which allows to control probable hemorrhages secondary to the surgical resection of the tumor. The benefits of this sort of embolization have been partially demonstrated. However, there are concrete and objective results, as reduction in bleeding, time of surgery, post-operative hospital stay, and the use of blood transfusion; besides, another benefit reported is the lower morbimortality related to the surgical management of neural tissue and vascular structures. The aim of this article was to bring up to date the available information up to this moment, describe briefly the background of the pre-operative embolization of skull base tumors, and emphasize the knowledge related with the variables of this therapy, such as the types of hypervascular tumors, vascular anatomy related to this (according to type and position of the tumor), the types of embolization therapy in hypervascular tumors, as well as the materials that must be used.

