Document Detail

The Risk Factors of Symptomatic Communicating Hydrocephalus After Stereotactic Radiosurgery for Unilateral Vestibular Schwannoma: The Implication of Brain Atrophy.
MedLine Citation:
PMID:  22494587     Owner:  NLM     Status:  Publisher    
PURPOSE: To identify the effect of brain atrophy on the development of symptomatic communicating hydrocephalus (SCHCP) after stereotactic radiosurgery (SRS) for sporadic unilateral vestibular schwannomas (VS). METHODS AND MATERIALS: A total of 444 patients with VS were treated with SRS as a primary treatment. One hundred eighty-one patients (40.8%) were male, and the mean age of the patients was 53 ± 13 years (range, 11-81 years). The mean follow-up duration was 56.8 ± 35.8 months (range, 12-160 months). The mean tumor volume was 2.78 ± 3.33 cm(3) (range, 0.03-23.30 cm(3)). The cross-sectional area of the lateral ventricles (CALV), defined as the combined area of the lateral ventricles at the level of the mammillary body, was measured on coronal T1-weighted magnetic resonance images as an indicator of brain atrophy. RESULTS: At distant follow-up, a total of 25 (5.6%) patients had SCHCP. The median time to symptom development was 7 months (range, 1-48 months). The mean CALV was 334.0 ± 194.0 mm(2) (range, 44.70-1170 mm(2)). The intraclass correlation coefficient was 0.988 (95% confidence interval [CI], 0.976-0.994; p < 0.001). In multivariate analysis, the CALV had a significant relationship with the development of SCHCP (p < 0.001; odds ration [OR] = 1.005; 95% CI, 1.002-1.007). Tumor volume and female sex also had a significant association (p < 0.001; OR = 1.246; 95% CI, 1.103-1.409; p < 0.009; OR = 7.256; 95% CI, 1.656-31.797, respectively). However, age failed to show any relationship with the development of SCHCP (p = 0.364). CONCLUSION: Brain atrophy may be related to de novo SCHCP after SRS, especially in female patients with a large VS. Follow-up surveillance should be individualized, considering the risk factors involved for each patient, for prompt diagnosis of SCHCP.
Jung Ho Han; Dong Gyu Kim; Hyun-Tai Chung; Sun Ha Paek; Chul-Kee Park; Chae-Yong Kim; Seung-Sik Hwang; Jeong-Hoon Park; Young-Hoon Kim; Jin Wook Kim; Yong Hwy Kim; Sang Woo Song; In Kyung Kim; Hee-Won Jung
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-4-10
Journal Detail:
Title:  International journal of radiation oncology, biology, physics     Volume:  -     ISSN:  1879-355X     ISO Abbreviation:  -     Publication Date:  2012 Apr 
Date Detail:
Created Date:  2012-4-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7603616     Medline TA:  Int J Radiat Oncol Biol Phys     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Elsevier Inc. All rights reserved.
Department of Neurosurgery, Seoul National University Bundang Hospital, Gyeonggi-do, Korea; Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea.
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