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CC BY-NC-ND 4.0 · Asian J Neurosurg 2022; 17(03): 500-506
DOI: 10.1055/s-0042-1756626
Case Report

Preoperative Transarterial Embolization of a Large Petrotentorial Angiomatous Meningioma Using Combination of Liquid Embolic Materials: A Case Report

Prasert Iampreechakul
1   Department of Neurosurgery, Prasat Neurological Institute, Bangkok, Thailand
,
Sarunya Yuthagovit
1   Department of Neurosurgery, Prasat Neurological Institute, Bangkok, Thailand
,
Korrapakc Wangtanaphat
1   Department of Neurosurgery, Prasat Neurological Institute, Bangkok, Thailand
,
Sunisa Hangsapruek
2   Department of Neuroradiology, Prasat Neurological Institute, Bangkok, Thailand
,
Punjama Lertbutsayanukul
2   Department of Neuroradiology, Prasat Neurological Institute, Bangkok, Thailand
,
Samasuk Thammachantha
3   Department of Pathology, Prasat Neurological Institute, Bangkok, Thailand
,
Somkiet Siriwimonmas
4   Department of Radiology, Bumrungrad International Hospital, Bangkok, Thailand
› Author Affiliations Funding None.
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Abstract

Intracranial angiomatous meningiomas are a rare WHO grade I histological variant of meningioma whose vascular component exceeds 50% of the total tumor area. Preoperative embolization of angiomatous meningiomas has rarely been reported previously. A 58-year-old woman was referred to our institute for a large petrotentorial hypervascular tumor presented with progressively worsening right facial paralysis and hearing loss for 6 months. Cranial computed tomography scan and magnetic resonance imaging revealed a large homogenously enhancing multilobulated mass involving middle and posterior cranial fossae with marked brainstem compression. The tumor extended into a right internal auditory canal and labyrinthine structures with destructive changes of bony structures. Magnetic resonance angiography showed hypervascularity in the tumor. Preoperative transarterial embolization using liquid embolic materials was successfully performed with resulting in almost complete devascularization of the tumor. Adequate hemostasis was achieved following gross total resection of the tumor (Simpson grade II). A histopathological examination confirmed the diagnosis of an angiomatous meningioma. Preoperative transarterial embolization of angiomatous meningioma with liquid embolic material was safe and effective in reducing perioperative blood loss and facilitating total tumor resection.

Keywords

preoperative embolization - brain tumor - angiomatous meningioma


Publication History

Article published online:
08 October 2022

© 2022. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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