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Preoperative embolization of intracranial meningiomas
Abstract:
The operative and histopathological findings in 31 cases of intracranial meningioma after preoperative embolization with Gelfoam and/or lyophilized dura mater are reported. Removal of the tumor after embolization was facilitated in those meningiomas fed exclusively or mainly by branches of the external carotid artery (29 of 31). Large areas of tumor necrosis were never seen on histopathological examination, even when suggested by large regions of decreased density on the postembolization computed tomographic scan. Preoperative embolization of the feeding vessels arising from the external carotid artery system has proven to be a useful adjunct before the resection of intracranial meningiomas.
Insights
Preoperative embolization of external carotid artery branches significantly aids intracranial meningioma removal. Histopathology confirmed embolization facilitated surgery but did not cause widespread tumor necrosis.
Area of Science:
- Neurosurgery
- Vascular Interventional Radiology
- Surgical Oncology
Background:
- Intracranial meningiomas are common primary tumors of the central nervous system.
- Surgical resection is the primary treatment modality for symptomatic meningiomas.
- Preoperative embolization is sometimes used to reduce tumor vascularity and facilitate resection.
Purpose of the Study:
- To report the operative and histopathological findings in patients with intracranial meningioma after preoperative embolization.
- To evaluate the efficacy and safety of preoperative embolization using Gelfoam and/or lyophilized dura mater.
Main Methods:
- Retrospective review of 31 patients with intracranial meningioma who underwent preoperative embolization.
- Embolization was performed using Gelfoam and/or lyophilized dura mater to occlude feeding vessels.
- Operative findings and histopathological examination were analyzed post-resection.
Main Results:
- Tumor removal was facilitated in 29 out of 31 cases, particularly those primarily supplied by the external carotid artery.
- No significant tumor necrosis was observed histopathologically, despite imaging suggesting decreased density.
- Embolization proved to be a useful adjunct in the surgical management of these tumors.
Conclusions:
- Preoperative embolization of external carotid artery branches is a beneficial adjunct for intracranial meningioma resection.
- While embolization aids surgical removal, it does not induce significant tumor necrosis.
- Further research may explore optimal embolization techniques and agents for meningioma treatment.