Preoperative embolization of meningiomas with pial supply: successful treatment of two cases.

Background: The efficacy of preoperative embolization for hypervascular meningiomas fed by the pial branches of the internal carotid artery was evaluated.

Methods: Two cases of hypervascular meningiomas fed by the cortical branches of the internal carotid arteries are presented. In the first patient, the left anterior frontal internal artery was embolized with gelatin sponge (Gelfoam) as a preoperative treatment using a microcatheter. The tumor was totally resected with 1,000 ml of blood loss. In the second patient, the right sulcal artery was embolized with Gelfoam. The patient subsequently underwent surgical resection with 100 mL of blood loss.

Results: No neurological deficit appeared after the embolization or the surgery in either case.

Conclusions: Preoperative embolization of hypervascular meningiomas, mainly fed by the cortical branches of the internal carotid arteries, may be possible and effective.