Hypervascular vestibular schwannomas

Surgical Neurology
Iwao YamakamiAkira Yamaura

Abstract

Vestibular schwannoma (VS) is usually hypovascular and can be resected totally without major morbidity. Resection of the more uncommon hypervascular VS is complicated by excessive tumor bleeding. We have attempted to clarify the clinical characteristics and management of hypervascular VS. Surgical reports and videos of 78 patients with unilateral VS (5 hypervascular, 73 nonhypervascular) were retrospectively reviewed and clinical characteristics, radiological findings, and case management were compared. Hypervascular VS presented at a younger age than nonhypervascular VS (29 +/- 12 vs. 52 +/- 16 years old) (p < 0.01). Magnetic resonance imaging (MRI) showed that hypervascular VS was solid, without tumor cyst, and significantly larger than nonhypervascular VS (p < 0.05). The surface of hypervascular VS consistently showed multiple flow voids representing large draining veins. The characteristic angiographical findings of hypervascular VS were extensive tumor vessels, tumor stains, and early filling of draining veins; vertebrobasilar arteries supplied hypervascular VS. A multi-stage surgical approach was used since torrential tumor bleeding in the first surgery interfered with resection, resulting in partial tumor removal. Angiog...Continue Reading

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Citations

Dec 11, 2002·Neurologia Medico-chirurgica·Iwao YamakamiAkira Yamaura
Dec 1, 2009·Journal of Neurosurgery·Michael E SughrueAndrew T Parsa
Aug 2, 2011·Journal of Neurosurgery·Brendan FongIsaac Yang
Feb 18, 2014·Journal of Neurosurgery·Ian F DunnOssama Al-Mefty
Feb 27, 2010·Journal of Magnetic Resonance Imaging : JMRI·Hiroki KatoYoshinobu Hirose
Oct 18, 2016·Case Reports in Radiology·Jordan NeputeYihua Zhou
Jun 12, 2012·Interventional Neuroradiology : Journal of Peritherapeutic Neuroradiology, Surgical Procedures and Related Neurosciences·H A RiinaJ A Boockvar
May 1, 2021·Vestnik otorinolaringologii·A I KrukovA V Zelenkov
Aug 18, 2021·Radiology Case Reports·Priya RaoRajiv Mangla
May 30, 2020·Journal of Neurosurgery. Pediatrics·Giselle E K MalinaDouglas E Anderson

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