Sporadic cerebellar hemangioblastomas and the role of cyst size in surgical outcomes – a single-surgeon experience from a single center

Czech version

Authors: O. Altunyuva ¹; N. Balcin ¹; A. I. Ozmarasali ¹; O. Balcin ²; S. Yilmazlar ¹
Authors‘ workplace: Department of Neurosurgery, Bursa Uludag University School of Medicine, Bursa, Turkey ¹; Department of Biostatistics, Bursa Uludag University School of Medicine, Bursa, Turkey ²
Published in: Cesk Slov Neurol N 2025; 88(6): 357-364
Category: Original Paper
doi: https://doi.org/10.48095/cccsnn2025357

Overview

Aim: Hemangioblastomas are benign, highly vascular tumors that originate within the central nervous system. Histologically, these tumors are composed of stromal cells embedded in a dense network of blood vessels. The aim of the study was to present our surgical outcomes in sporadic cerebellar hemangioblastomas and to investigate the relationship between the cystic component size and the presence of hydrocephalus and associated clinical findings. Materials and methods: We retrospectively reviewed 29 adult patients with sporadic cerebellar hemangioblastomas operated by a single surgeon between 2010 and 2022. Tumors were classified as solid, small cystic (< 2.5 cm), or large cystic (≥ 2.5 cm). Clinical, imaging, and surgical data were analyzed, and functional outcomes were measured using the modified Rankin Scale (mRS) and Karnofsky Performance Scale (KPS) scores. The relationship between cyst size, hydrocephalus, and neurological outcome was also examined. Results: Larger cysts were significantly linked to hydrocephalus (P = 0.038) and cerebellar symptoms (P = 0.026). Regression suggested a possible association between cyst size and these findings (P = 0.062 and P = 0.053). Cyst and nodule sizes showed moderate correlation (r = 0.520; P = 0.013). Cysts were also larger in patients needing an external ventricular drain (41,00 vs. 28,78 mm; P = 0.053). No significant differences were found between groups in mRS or KPS scores before and 1 year after surgery (P > 0.6). Conclusion: Hemangioblastomas are benign, but their posterior fossa location often causes significant symptoms. En bloc resection of the nodule with wide craniotomy remains the best treatment. This study highlights the link between large cysts and hydrocephalus, suggesting early surgery may improve outcomes.

Keywords:

cyst – hydrocephalus – hemangioblastoma – posterior fossa

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Article was published in

Czech and Slovak Neurology and Neurosurgery

2025 Issue 6

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