Blood supply of acoustic neurinomas

The arterial blood supply of acoustic neurinomas is reviewed on the basis of normal and pathological anatomical findings as well as neuroradiological and intra-operative observations. Available data suggest that, as a rule, the tumour primarily receives blood from the external carotid by way of dural vessels, with the occipital artery playing a prominent role. The cerebellar vessels, including the anterior inferior cerebellar artery, are apparently no more than secondary contributors. In the light of these observations, selective external carotid angiography on the diseased side is recommended in acoustic neurinomas. In hypervascularized neurinomas preoperative embolization of afferent external carotid branches is discussed as a potential supplementary procedure.