Baro Valentina, Gabrieli Joseph Domenico, Cester Giacomo, D'Errico Ignazio, Landi Andrea, Denaro Luca, Causin Francesco
Academic Neurosurgery, Department of Neuroscience, University of Padova, 35100 Padova, Italy.
Neuroradiology Unit, University of Padova, 35100 Padova, Italy.
Brain Sci. 2021 Apr 25;11(5):540. doi: 10.3390/brainsci11050540.
(1) Background: Surgical treatment of choroid plexus tumors is challenging, burdened by a notable risk of bleeding. Neoadjuvant chemotherapy and preoperative embolization have been attempted, with encouraging results; however, the consensus on these procedures is lacking. (2) Methods: We present a case of a 10-month-old girl who underwent preoperative embolization of a hemorrhagic choroid plexus carcinoma of the lateral ventricle via the anterior choroidal artery, followed by total resection. (3) Results: The endovascular procedure was successfully completed, despite the rectification of the anterior choroidal artery associated with the absence of flow proximal to the plexal point. Minimal bleeding was observed during resection and the patient remained neurologically intact. (4) Conclusions: The time from entrance to exit in the anterior choroidal artery should be monitored and regarded as a potential 'occlusion time' in this specific group of patients. Nevertheless, our case supports the feasibility and effectiveness of preoperative embolization of a choroid plexus carcinoma of the lateral ventricle via the anterior choroidal artery, without complications. Furthermore, we suggest the use of a fast-embolic agent, such as N-butyl cyanoacrylate glue, as the preferred agent for this specific pathology and patient population.
（1）背景：脉络丛肿瘤的外科治疗具有挑战性，存在显著的出血风险。新辅助化疗和术前栓塞已被尝试，结果令人鼓舞；然而，对于这些手术尚无共识。（2）方法：我们报告一例10个月大女孩的病例，她通过脉络膜前动脉对侧脑室出血性脉络丛癌进行了术前栓塞，随后进行了全切术。（3）结果：尽管矫正了脉络膜前动脉且在丛状点近端无血流，但血管内手术仍成功完成。切除过程中观察到少量出血，患者神经功能保持完好。（4）结论：在这一特定患者群体中，应监测脉络膜前动脉的进出时间并将其视为潜在的“闭塞时间”。尽管如此，我们的病例支持通过脉络膜前动脉对侧脑室脉络丛癌进行术前栓塞的可行性和有效性，且无并发症。此外，我们建议使用快速栓塞剂，如氰基丙烯酸正丁酯胶，作为针对这种特定病理和患者群体的首选药物。
