1.Multi-modal management of aggressive vertebral hemangioma: A single center experience
Mohamed FAROUK ; Mohamed Ali KASSEM ; Ashraf EZZELDEIN ; Mohamed Mohsen AMEEN ; Ali Hassan ELMOKADEM ; Mohamed M ELSHERBINI
Journal of Cerebrovascular and Endovascular Neurosurgery 2025;27(1):40-49
Objective:
This study aims at spotlighting different lines of management of aggressive vertebral hemangioma (VH) through a retrospective analysis of single center experience.
Methods:
Patients diagnosed with aggressive VHs in a tertiary referral center were reviewed from 2014 through 2024. Data of patients who met the inclusion criteria were analyzed. Patients of all ages, both sexes, and all varieties of clinical presentation were included, only patients who underwent at least one intervention were included.
Results:
The study included nine patients, comprising six females and three males, with a mean age of 29.3 years (ranging from 14 to 46). Six patients underwent Trans-arterial embolization (TAE), of whom five underwent further surgical procedures, while one patient found TAE to be sufficient as a stand-alone management technique. Eight patients underwent surgical management, five of whom were pre-operatively embolized.
Conclusions
Aggressive VHs are rare, and their management is challenging. Most cases require a multi-modal management, especially when presented with neurological deficit. Pre-operative embolization and/or vertebroplasty are safe and useful tools to decrease intra-operative bleeding of such a vascular pathology in cases undergoing open surgical procedures.
2.Multi-modal management of aggressive vertebral hemangioma: A single center experience
Mohamed FAROUK ; Mohamed Ali KASSEM ; Ashraf EZZELDEIN ; Mohamed Mohsen AMEEN ; Ali Hassan ELMOKADEM ; Mohamed M ELSHERBINI
Journal of Cerebrovascular and Endovascular Neurosurgery 2025;27(1):40-49
Objective:
This study aims at spotlighting different lines of management of aggressive vertebral hemangioma (VH) through a retrospective analysis of single center experience.
Methods:
Patients diagnosed with aggressive VHs in a tertiary referral center were reviewed from 2014 through 2024. Data of patients who met the inclusion criteria were analyzed. Patients of all ages, both sexes, and all varieties of clinical presentation were included, only patients who underwent at least one intervention were included.
Results:
The study included nine patients, comprising six females and three males, with a mean age of 29.3 years (ranging from 14 to 46). Six patients underwent Trans-arterial embolization (TAE), of whom five underwent further surgical procedures, while one patient found TAE to be sufficient as a stand-alone management technique. Eight patients underwent surgical management, five of whom were pre-operatively embolized.
Conclusions
Aggressive VHs are rare, and their management is challenging. Most cases require a multi-modal management, especially when presented with neurological deficit. Pre-operative embolization and/or vertebroplasty are safe and useful tools to decrease intra-operative bleeding of such a vascular pathology in cases undergoing open surgical procedures.
3.Multi-modal management of aggressive vertebral hemangioma: A single center experience
Mohamed FAROUK ; Mohamed Ali KASSEM ; Ashraf EZZELDEIN ; Mohamed Mohsen AMEEN ; Ali Hassan ELMOKADEM ; Mohamed M ELSHERBINI
Journal of Cerebrovascular and Endovascular Neurosurgery 2025;27(1):40-49
Objective:
This study aims at spotlighting different lines of management of aggressive vertebral hemangioma (VH) through a retrospective analysis of single center experience.
Methods:
Patients diagnosed with aggressive VHs in a tertiary referral center were reviewed from 2014 through 2024. Data of patients who met the inclusion criteria were analyzed. Patients of all ages, both sexes, and all varieties of clinical presentation were included, only patients who underwent at least one intervention were included.
Results:
The study included nine patients, comprising six females and three males, with a mean age of 29.3 years (ranging from 14 to 46). Six patients underwent Trans-arterial embolization (TAE), of whom five underwent further surgical procedures, while one patient found TAE to be sufficient as a stand-alone management technique. Eight patients underwent surgical management, five of whom were pre-operatively embolized.
Conclusions
Aggressive VHs are rare, and their management is challenging. Most cases require a multi-modal management, especially when presented with neurological deficit. Pre-operative embolization and/or vertebroplasty are safe and useful tools to decrease intra-operative bleeding of such a vascular pathology in cases undergoing open surgical procedures.
4.Efficiency of decompressive craniectomy as a line of management of severe cerebral venous thrombosis
Mohamed M ELSHERBINI ; Hatem BADR ; Amr Farid KHALIL
Journal of Cerebrovascular and Endovascular Neurosurgery 2022;24(2):129-136
Objective:
Cerebral venous thrombosis (CVT) is a rare pathology with life threatening consequences, most of these fatal complications are due to raised intracranial pressure due to venous infarction and cerebral swelling, the purpose of this study is to evaluate the efficiency of decompressive craniectomy for favorable outcome.
Methods:
A retrospective analysis of clinical, radiological and surgical data of patients who underwent decompressive craniectomy for CVT in a tertiary referral hospital between the years 2016 through 2020.
Results:
The study included 7 patients, female predominance was noted (5/7), mean age was 18.14 years. Mean Glasgow coma score (GCS) at surgery was 8.26, good clinical outcome was achieved for the majority of cases 71.4%, and one case of mortality 14.28%.
Conclusions
Decompressive craniectomy is a life saving procedure for patients with severe brain swelling as a sequela of CVT, majority of patients (71.4%) showed favorable functional outcome by 6 months postoperatively.