We carried out embolisation with phenytoin in seven patients with meningiom
as; in three by cannulation of the middle meningeal artery during surgery a
nd in four by microcatheter introduced into the middle meningeal artery. Ph
enytoin (125-500 mg) diluted with saline (25 mg/ml) was injected slowly as
a bolus. There was no evidence of devascularisation in two meningiomas trea
ted with 125 mg and 150 mg of phenytoin, Large areas of ischaemic and haemo
rrhagic necrosis were found in five meningiomas treated with 250-500 mg, Af
ter embolisation, the tumour blush disappeared, with preservation of the fe
eding arteries. Total resection of the tumour was performed with minimum bl
ood loss, Caution and proper use are emphasised to avoid increase in tumour
volume and reflux, Phenytoin could be a suitable material for superselecti
ve embolisation.