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Relevance of the Foramen of Vesalius for Preoperative Tumor Embolization in Skull Base Meningioma.
- Source :
-
World neurosurgery [World Neurosurg] 2024 Jul; Vol. 187, pp. e501-e508. Date of Electronic Publication: 2024 Apr 26. - Publication Year :
- 2024
-
Abstract
- Objective: The objective of this study was to investigate the role of the foramen of Vesalius (FV) in the pathogenesis of skull base meningioma by analyzing data from various multi-image modalities.<br />Methods: For this single-center retrospective study, 39 consecutive patients with skull base meningioma who underwent tumor resection between January 2020 and March 2023 were enrolled. The anatomical and pathological characteristics of the FV were evaluated using computed tomography and 3-dimensional digital subtraction angiography. The clinical significance of the FV in tumor hemodynamics and treatment, such as preoperative tumor embolization, was investigated using the 3-dimensional digital subtraction angiography/computed tomography fusion images.<br />Results: We identified FV in 52% (17/27) of the finally included patients. In 10 (30%) patients, the FV was found bilaterally with no significant variation in appearance between the healthy and tumor-affected sides (P = 0.786). The mean FV diameter was significantly larger on the tumor-affected side (P = 0.010). No significant anatomical differences, like duplication and partial assimilation with the foramen ovale, were observed between the 2 sides. The FV was involved in venous skull base perfusion around the tumor in 9 cases. In 4 cases where it was the pathway for tumor feeders, preoperative tumor embolization via the FV resulted in disappearance of the tumor stain. No complications associated with endovascular treatment were observed.<br />Conclusions: This study elucidated the anatomical asymmetry of the FV and its role in the hemodynamics of skull base meningioma. Our findings highlight the significance of performing anatomical and pathological evaluations of the FV in determining treatment strategies, including preoperative embolization, for skull base lesions.<br /> (Copyright © 2024 Elsevier Inc. All rights reserved.)
- Subjects :
- Humans
Female
Male
Middle Aged
Retrospective Studies
Aged
Adult
Preoperative Care methods
Imaging, Three-Dimensional
Tomography, X-Ray Computed
Meningioma surgery
Meningioma diagnostic imaging
Meningioma therapy
Skull Base Neoplasms surgery
Skull Base Neoplasms diagnostic imaging
Skull Base Neoplasms therapy
Embolization, Therapeutic methods
Meningeal Neoplasms diagnostic imaging
Meningeal Neoplasms surgery
Meningeal Neoplasms therapy
Angiography, Digital Subtraction
Subjects
Details
- Language :
- English
- ISSN :
- 1878-8769
- Volume :
- 187
- Database :
- MEDLINE
- Journal :
- World neurosurgery
- Publication Type :
- Academic Journal
- Accession number :
- 38679376
- Full Text :
- https://doi.org/10.1016/j.wneu.2024.04.116