Preoperative Embolization of Cerebellar Hemangioblastoma with Onyx: Report of Three Cases
A 53-year-old man presented with a 15 day history of progressive vertigo and occipital headache. Brain MRI revealed a 3.2 × 2.2 cm cystic tumor with a 1.0 × 0.5 cm sized densely enhancing mural nodule in the right cerebellum (). A diagnostic vertebral angiogram revealed early intense tumor staining in the right cerebellum from the right superior cerebellar artery with AV shunt showing a highly vascular lesion (). The patient underwent Onyx embolization of core feeder vessel originated off the right superior cerebellar artery and tumor blush was complete resolved (). Near total resection of the tumor was performed with minimal blood loss. Post operative MRI revealed volume reduction over 90% of enhancing mural nodule with nearly total regression of the cystic portion. The tumor was pathologically confirmed as hemangioblastoma. After surgical resection, vertigo and occipital headache were gradually resolved.