Brain and spinal tumors are clumps of abnormal cells in your brain or spinal cord that have grown wildly. Some of these tumors are malignant (cancerous) and can spread throughout the body. Others are benign (noncancerous), and these can press against or destroy normal brain tissue. Many benign tumors in the brain and spinal cord have many blood vessels (vascular), which makes them difficult or dangerous to remove surgically. If you have a vascular tumor, you often need a multidisciplinary team of specialists for treatment.

Some head and neck tumors are located close to major blood vessels such as the carotid artery. In those cases, it becomes more complicated to plan a safe surgery to remove the tumor. Balloon occlusion testing enables us to see if we can safely close off an artery before surgery. Closing off the artery will shut off the blood flow during surgery, avoiding hemorrhage. However, closing off the artery can also cause stroke.

At Mount Sinai, we use balloon occlusion testing to determine whether other arteries supplying blood to the brain can take over if we close a particular artery. We start by performing an angiogram, an X-ray that uses contrast dye to highlight certain parts of the body. Then we inflate a balloon inside the vessel, temporarily blocking its blood flow. This helps us see whether the other arteries are able to compensate for the blocked artery so we can plan the safest surgery for you.

Treatments Available

At Mount Sinai, we typically use one of two techniques to treat brain and spinal tumors:

Endovascular embolization helps us shrink a tumor and decrease its blood supply. To close (embolize) a blood vessel, we insert a catheter and thread it to the targeted blood vessel. Once the catheter is in place, we use the catheter to deliver coils, balloons, stents, or “glues” to close up the vessel.  By closing the blood vessel, we can more safely and successfully surgically remove the tumor. In cases where we cannot remove the tumor, endovascular embolization can help by reducing pain or other symptoms caused by the tumor.

Infusion therapy involves delivering cancer-fighting medication (chemotherapy) directly to the site of the tumor. Historically, we have provided chemotherapy through a pill or by injecting it into the bloodstream. By bringing chemotherapy directly to the tumor, we can decrease the side effects while providing a higher dose of chemotherapy to the tumor.