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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 26:1413-1419, June-July 2005
© 2005 American Society of Neuroradiology

INTERVENTIONAL

Neurologic Complications after Particle Embolization of Intracranial Meningiomas

Martin Bendszus^a, Camelia Maria Monoranu^b, Ansgar Schütz^a, Ingo Nölte^a, Giles H. Vince^c and László Solymosi^a

^a Department of Neuroradiology, University of Würzburg, Würzburg, Germany
^b Department of Neuropathology, University of Würzburg, Würzburg, Germany
^c Department of Neurosurgery, University of Würzburg, Würzburg, Germany

Address reprint requests to Dr Martin Bendszus, Department of Neuroradiology, University of Würzburg, Josef-Schneider-Strasse 11, D-97080, Würzburg, Germany

BACKGROUND AND PURPOSE: Preoperative embolization of meningiomas is frequently used to facilitate surgery and to reduce intraoperative blood loss. The purpose of this study was to evaluate the frequency of procedure-related neurologic complications during and after particle embolization of intracranial meningiomas.

METHODS: Between 1996 and 2004, 185 consecutive patients underwent particle embolization of an intracranial meningioma. Devascularization was performed by means of superselective probing of the tumor-feeding vessels and ensuing free-flow embolization with spherical particles. All procedures were performed with systemic heparinization.

RESULTS: Six patients (3.2%) had ischemic events with neurologic deficit. Two had amaurosis, and four patients presented with hemiparesis. Hemorrhage occurred in six patients (3.2%). In five of these patients, rapid microsurgical tumor removal resulted in a favorable outcome without persistent neurologic deficit. In one patient, massive intratumoral, subarachnoid, and subdural hemorrhage was lethal.

CONCLUSION: Particle embolization of meningiomas is associated with a substantial risk of ischemic and hemorrhagic events. The individual risk-to-benefit ratio of embolization should be thoroughly considered.

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