Martínez-Ponce LA, Garza-Mercado R, Tamez-Montes D, Elizondo-Riojas G, Morales-García VD

Language: Spanish
References: 7
Page: 156-159
PDF size: 171.20 Kb.

ABSTRACT

Objective: to demonstrate postembolization tumoral necrosis in patients with intracraial meningiomas before operation. Material and methods: The report includes 4 patients with intracranial meningiomas: 3 supratentorial and 1 infratentorial. They all underwent angioem-bolization with AVP and N-butyl-cianocrylate supraselective in branches of external carotid. Seven days later they all had MRI which demonstrated total embolization. A follow up was carried out on all these patients, starting from clinical preparation to 6 months postoperatory surgical registrations for verification. Results: Seven days postembolization there was tumoral necrosis, demonstrated by MRI and transoperatory confirmation. There was no increment of peritumoral cerebral edema neither neurological deterioration related to angioembolization. There was facility to resection of meningioma secondary to necrosis, better aspiration, diminishing operatory time and hemorrhage. All patients had excellent clinical evolution. There was confirmation for pathology of tumoral necrosis. Conclusion: The preoperatory angioembolization is effective to produce tumoral necrosis in intracraneal meningiomas when it carried out at 100%, evidenced on the seventh day.

REFERENCES

1. Mc Dermott M, Wilson B. Meningiomas, in Youmans JR (ed): Neurological surgery. 4. Philadelphia: WB Saunders, 1996.

2. Ahuja A, Gibbons KJ, Hopkins LN. Endovascular techniques to treat brain tumors, in Youmans JR (ed): Neurological surgery, Ed 4. Philadelphia: WB Saunders 1996;2826-40.

3. Chun J, McDermott M, Lamborn K, Wilson C, Higashida R. Delayed surgical resection reduces intraoperative blood loss for embolized meningiomas. Neurosurgery 2002;50:1231-37.

4. Bendszus M, Rao G, Burger R, Schaller C, Scheineman K. Is there a benefit of preoperative meningioma embolization?. Neurosurgery 2000;47:1306-11.

5. Kai Y, Hamada J, Morioka M. Appropriate interval between embolization and surgery in patients with meningioma. AJNR 2002;23:139-42.

6. Hayashi T, Shojima K, Utsunomiya H. Subarachnoid hemorrhage after preoperative embolization of a cyst meningioma. Surg Neurol 1974; 27:295-398.

7. Adler J, Upton J, Wallman J. Management and prevention of necrosis of the scalp after embolization and surgery for meningioma. Surg Neurol 1986;25:357-60.