Introduction: Solid cerebellar hemangioblastomas are highly vascular tumors that may cause severe hemorrhage during surgical resection.
Methods: we reviewed the records of 11 patients operated for the resection of solid cerebellar hemangioblastoma at the neurosurgery Department, Alexandria University, Egypt,in the period between 2008 and 2015. All cases had pre-operative tumor embolization prior to surgery.
Results: There were 7 men and 4 women, with a mean age of 38 years. Three patients had confirmed Von Hippel–Lindau disease. The average tumor size was 40.7?±?8.7?mm in its maximal diameter. Three patients in this series experienced failed surgery elsewhere due to massive intraoperative bleeding before being referred to our facility. The most common presenting symptoms were headache and ataxia which were present in all cases.
Total endovascular occlusion was possible in six patients, near total occlusion was carried out in three patients, and incomplete occlusion in 2 cases. Nine patients (82%) underwent gross total resection and in 2 cases only subtotal resection was possible.Blood loss during surgery was minimal and controllable. Eight patients (73%)experienced post-operative improvement of their symptoms and the remaining cases maintained their pre-treatment status.
Conclusions: Preoperative embolization improves safety and efficacy of the surgical excision of these tightly located, highly
vascular tumors.
Patient Care: this technique minimizes intra-operative bleeding making excision of these tumors safer.
Learning Objectives: define the role of pre-operative embolization in the management of solid cerebellar hemangioblastoma