Preoperative embolization of skull–base tumors: Indications, utility, and concerns

Abstract

Skull-base tumors are generally difficult to access compared with many other cranial lesions. Usually surgery remains the gold standard treatment for the majority of these tumors. However, in many cases, surgical resection is a challenge because the disease usually is already in the advanced stage by the time of diagnosis. Additionally, there are hypervascular lesions which cause excessive loss of blood, then results in multiple blood transfusions and prolonged operative time, increases the risk of neural injury and prevents complete excision. In order to reduce blood loss intraoperatively, many alternatives were available with the neurosurgical armamentarium, such as head elevation, intravenous use of tranexamic acid, total intravenous anesthesia and even preoperative embolization of tumors. However, preoperative embolization carries variable results, potentially aggravating edema and increasing tumor size. To ascertain the current status and the up-to-date indications, an evaluation of the therapeutic role of preoperative embolization was performed in the current study.

Keywords

• Pre-operative
• Embolization
• Skull-base tumors