Neurologic complications after particle embolization of intracranial meningiomas

AJNR Am J Neuroradiol. 2005 Jun-Jul;26(6):1413-9.


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.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Embolization, Therapeutic / adverse effects*
  • Female
  • Humans
  • Male
  • Meningeal Neoplasms / therapy*
  • Meningioma / therapy*
  • Middle Aged
  • Nervous System Diseases / epidemiology
  • Nervous System Diseases / etiology*
  • Particle Size