Embolization of Posterior Fossa Meningiomas Supplied with Meningohypophyseal Trunk by Using n-BCA and Dual Balloon Protection.

Abstract

Background and purpose: Efficacy of tumor embolization for posterior fossa meningioma is controversial due to the lack of adequate embolization for dangerous feeders. Of these, a meningohypophyseal trunk (MHT) has high therapeutic value despite the high risks associated with embolization.

Materials and methods: To analyze the utility of preoperative MHT embolization for posterior fossa meningiomas by using n-BCA with dual balloon protection, a single-center retrospective record review was performed on 8 consecutive patients who underwent preoperative tumor embolization via the MHT for posterior fossa meningiomas between 2020 and 2024.

Results: In all cases the MHT was successfully embolized by using n-BCA. Complete obliteration was achieved in 5 cases, which is related to the tentorial artery alone as the feeding vessel. None of the patients had cerebral infarction associated with distal embolization. One patient experienced worsening of preoperatively observed abducens nerve palsy due to cranial nerve ischemia. Gross total resection was achieved in 7 of 8 cases. The mean estimated blood loss during surgical resection was 186 mL (range, 39-392 mL). The mean operative time was 431 minutes (range, 317-767 minutes).

Conclusions: The MHT embolization of posterior fossa meningiomas by using n-BCA is technically feasible with a high success rate and an acceptable complication rate.