Lethal Complication of Preoperative Embolization for a Glomus Jugulare Tumor

Abstract

Introduction: Preoperative embolization of meningiomas and glomus jugulare tumors is performed routinely in many centers because it decreases intraoperative bleeding, shortens operative time, and allows for more orderly microdissection. The major recognized risks from glomus jugulare embolization are strokes and cranial nerve deficits. There have been seven cases reported of meningioma hemorrhage following embolization. We present a case of fatal subarachnoid hemorrhage after embolization of a glomus jugulare tumor. Methods: Case report and review of literature. Result: A 70-year-old female with a large recurrent glomus jugulare tumor with intracranial extension underwent preoperative embolization. During the procedure she suffered hemorrhage from the tumor into the subarachnoid and ventricular system with accompanying brainstem compression and hydrocephalus. Despite emergent ventriculostomy and medical management the patient did not recover and was declared brain dead. Post mortem examination revealed the source of bleeding to be a varix on the intracranial surface of the tumor. Conclusion: Subarachnoid hemorrhage is a rare but potentially lethal complication when a glomus jugulare tumor is embolized.