[Intra and parabulbomedullary hemangioblastomas].

Intra- and para-bulbomedullary hemangioblastomas are a relatively frequent topographic variety and represent about one third of the spinal cord cases. The surgical approach is particularly difficult in this location, because of adhesion or infiltration of the brain stem by the hemangioblastoma. The authors correlate the angiographic signs and the anatomical findings obtained during surgery. Four topographic types are described: intra-bulbomedullary tumors, usually allowing partial resection only; tumors of the floor of the IVth ventricle extending between the cerebellar tonsils without any infiltration of the brain stem, allowing complete resection; tumors of the cerebellar tonsils with a lateral para-bulbar extension which should allow complete resection, but present with difficult diagnostic problems on angiography; tumors of the cerebellar tonsils with a midline extension present with a particular difficult angiographic diagnosis, but should also allow complete resection.