The tumour in the left superior cerebellar hemisphere near the vermis, is markedly hypervascular, with a rapid arteriovenous shunting very large veins at the dorsal and superior surface of the tumour. There are numerous arterial enlarged feeding arteries, predominantly from the left superior cerebellar artery, but with contribution from a small posterior cerebral artery branch, and left posterior inferior cerebellar artery, and to lesser extent anterior inferior cerebellar artery. A 5-French guiding catheter was placed in the left vertebral artery, and a SL team microcatheter navigated in to the left superior cerebellar artery, well beyond the brainstem, with selective, and embolisation with PTA particles 150-250 micron. No neurologic complications, the procedure was tolerated well, there is good devascularisation of the tumour. Groin closure with six French AngioSeal device.
Conclusion: Marked decrease in tumour blush post pre operative embolisation of haemangioblastoma