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AJNR - American Journal of Neuroradiology

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Postembolization Hemorrhage of a Large and Necrotic Meningioma

Simon C. H. Yu^a, Ronald Boet^b, George K. C. Wong^b, Wynnie W. M. Lam^a and Wai S. Poon^b

^a Department of Diagnostic Radiology and Organ Imaging, Prince of Wales Hospital, Hong Kong, China
^b Division of Neurosurgery, Prince of Wales Hospital, Hong Kong, China

View larger version (109K): [in a new window]   FIG 1. Pre-embolization MR image, showing a large right falcine meningioma with central necrosis.

View larger version (109K): [in a new window]   FIG 2. Pre-embolization arteriogram, revealing the meningioma with hypervascular periphery and avascular center.

View larger version (109K): [in a new window]   FIG 3. Postembolization arteriogram, demonstrating contrast material extravasation from the anterior-inferior margin of the tumor. The bleeding site is superimposed with the catheter tip coincidentally in the lateral view. In fact, they are far separated.

View larger version (109K): [in a new window]   FIG 4. Postembolization CT image, demonstrating the presence of peritumoral hemorrhage at the anterior and inferior aspect of the embolized tumor, which is depicted as a zone of opacity located anterior to the densely contrast-enhanced and calcified meningioma, as well as subdural hemorrhage along the falx cerebri.

View larger version (109K): [in a new window]   FIG 5. Postembolization CT image, illustrating the presence of subarachnoid hemorrhage at the ambient cistern and Sylvian fissures.