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KMID : 0942820120110010028
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Journal of Korean Brain Tumor Society
2012 Volume.11 No. 1 p.28 ~ p.32
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Posterior Fossa Hemangioblastomas : Clinical Features and Surgical Outcomes
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Park Jung-Hoon
Kim Eal-Maan
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Abstract
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Objectives: Surgical treatment of hemangioblastomas (HBs) is complicated by their vascularity and the occurrence in the posterior cranial fossa. The authors elucidate clinical presentations, radiographic features, and surgical results in patients with infratentorial HBs.
Methods: Thirty-six consecutive patients (22 males ; mean age 46.5 years) with 40 infratentorial HBs were retrospectively enrolled. All patients were examined neurologically, radiologically, and pathologically to ascertain the therapeutic results and recurrence rates. Among 36 patients, there were two Von Hippel-Lindau disease and others were sporadic.
Results:The common symptoms before surgery were headache (53.0%), dizziness (42.0%), and vomiting (38.9%). On magnetic resonance images (MRI), 35 (87.5%) tumors were located in cerebellar hemisphere, 2 (5.0%) in cerebellar vermis, and 3 (7.5%) in the brain stem. Twenty-nine tumors (72.5%) were mainly cystic and the remaining were solid. The main feeding arteries were posterior inferior cerebellar arteries (PICAs) in twenty tumors (50%). Tumors were removed totally in 35 patients and subtotally in 1. Six patients (16.7%) showed a complicated postoperative course. Three patients (8.3%) required shunt surgery for obstructive hydrocephalus. Two recurrent tumor was notable 16 years and 5 years after surgery, respectively.
Conclusion: Most posterior fossa HBs can be safely resected based on the improved surgical planning by MRI and angiography. But, HBs involved brain stem still remains a challenging, with high rate of operative morbidity and mortality.
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KEYWORD
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Hemangioblastoma, Microsurgery, Posterior fossa, von Hippel-Lindau disease
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