Hemangioblastomas

Hemangioblastomas are true neoplasms of blood vessels. They can arise spontaneously, but they also can be associated with von Hippel-Lindau syndrome. In the spinal cord, they constitute 3.3% of intramedullary tumors and most commonly present in the fourth decade.20 Up to 30% of patients with spinal cord hemangioblastomas have von Hippel-Lindau syndrome. The majority of spinal hemangioblastomas (79%) are single. The thoracic cord is the most common site, followed by the cervical cord.20 Angiographically, they are very vascular lesions, often with arteriovenous shunting.

Therapy

A preoperative embolization significantly reduces the risk of a surgical resection21,22 (Figure 16.4).

Figure 16.4. (A) A hypervascu-lar intramedullary mass of the upper cervical region consistent with a hemangioblastoma. Major blood supply occurs through the C2 radicular artery (large arrow). Note the anterior spinal artery (small arrow). (B) Superselective placement of a microcatheter within the radicular artery for a preoperative PVA particle em-bolization. (C) Control an-giogram after complete devascu-larization.

Figure 16.4. (A) A hypervascu-lar intramedullary mass of the upper cervical region consistent with a hemangioblastoma. Major blood supply occurs through the C2 radicular artery (large arrow). Note the anterior spinal artery (small arrow). (B) Superselective placement of a microcatheter within the radicular artery for a preoperative PVA particle em-bolization. (C) Control an-giogram after complete devascu-larization.

HemangioblastomaHemangioblastomas

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