Successful Combined Preoperative Embolization and Surgical Resection of Large Posterior Fossa Hemangioblastomas: A 3-Case Series

Abstract Hemangioblastoma (HB), a benign, vascularized tumor of the central nervous system, is the most common posterior fossa tumor in adults. The treatment of choice is surgery. Due to its high vascularity, it can bleed during surgery. Therefore, preoperative angiography with embolization of its vascular landmarks has become increasingly popular to reduce intraoperative blood loss and improve surgical outcomes. The objective of this study was to present three cases of HB in the posterior fossa treated with preoperative embolization. Three patients presented: a 42-year-old woman, a 50-year-old man, both with symptoms of intracranial hypertension, and a 47-year-old man with cerebellar symptoms and low nerve function. In all three, brain computed tomography and magnetic resonance imaging showed images suggestive of large HBs. They were previously embolized. During surgery, there was minimal bleeding and complete resection, with good results. A series of three cases of patients with large posterior fossa HBs who received preoperative embolization was presented. Preoperative endovascular embolization is a valuable tool in the treatment of posterior fossa HBs. It reduces intraoperative bleeding and facilitates en bloc tumor resection, thereby improving postoperative outcomes.