| Περίληψη: | Meningiomas refer to a type of brain tumor that originates from the meninges and more
specifically from arachnoid cap cells. They appear more often in women aged 20–60
years. They account for 13 to 26% of primary intracranial tumors in adults and < 2% of
all intracranial tumors in children. Non-malignant meningioma is the most frequently
reported histologic type. Treating meningiomas has evolved over the past few decades
due to advanced diagnostic imaging, more effective surgical and neuroendovascular
procedures.
Our review of the literature revealed that preoperative embolization relies upon a
thorough knowledge of pertinent anatomy (including potential collaterals and cranial
nerve [CN] supply), careful analysis of tumoral blood supply, skillful catheterization of
feeding vessels and accurate delivery of the appropriate embolic agent.
It can be used safely in cases where the tumor is located in difficult areas, whereas special
attention is needed in case of dangerous anastomoses with cerebral vessels. Challenging
meningiomas include mainly those located at the sphenoid wing, middle cranial fossa
(MCF) and those located at the vicinity of cavernous sinus.
Current data suggests that preoperative embolization of meningiomas may reduce blood
loss during surgery and minimize transfusion requirements (red blood cells, platelets).
Therefore, embolization could effectively facilitate surgical procedure. There are no
findings that preoperative embolization diminishes meningioma recurrence rates after
surgery. The literature suggests a 3% to 6% neurological complication rate related to
embolization. These may include groin hematoma, contrast reaction, vessel dissection,
intra-tumoral hemorrhage and ischemic stroke. Overall, the maximum benefit of the
patient requires careful selection and preparation. Treatment should be applied in an
interdisciplinary manner, which depends on the preference of the neurosurgeon, the
location and blood supply of the tumor, as well as the surgical risk assessment. In this
study we aimed to overview the currently available data regarding the application of
preoperative embolization in cases of meningiomas.
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