ArticleJournal of neuroendovascular therapy2025
A Case of Hypervascular Vestibular Schwannoma with Ventricular Enlargement Improved by the Tumor Volume Reduction Effect of Preoperative Embolization.
Article in Journal of neuroendovascular therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: Reports on embolization of the feeding arteries for vestibular schwannomas are limited, and studies addressing the tumor volume reduction effect of embolization are similarly scarce. Here, we present a case of a patient with vestibular schwannoma and associated ventricular enlargement, in which preoperative embolization led to substantial tumor volume reduction and subsequent improvement in ventricular enlargement. Case Presentation: The patient was a 32-year-old man presenting with hearing loss, headache, nausea, unsteadiness, and loss of appetite. MRI displayed a left vestibular schwannoma with a maximum diameter of 38 mm and associated ventricular enlargement. Angiography displayed a hypervascular vestibular schwannoma with feeders from the left anterior inferior cerebellar artery (AICA) and the petrosal branch of the middle meningeal artery (MMA). Embolization was performed using 25% N-butyl cyanoacrylate for the AICA and 500-700-μm Embosphere microspheres diluted 60 times for the MMA. Symptomatic improvement was observed 2 days after the procedure. MRI conducted 4 days after the procedure showed a 19.8% reduction in tumor volume and mild ventricular shrinkage. The patient underwent tumor resection 7 days post-embolization and had a favorable postoperative course. Conclusion: Although the tumor volume reduction effect of preoperative embolization does not always lead to an improvement in ventricular enlargement, our present case demonstrates that preoperative embolization can contribute to the improvement of ventricular enlargement through its volume reduction effect.
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