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Intratumoral Hemorrhage in Vestibular Schwannomas After Stereotactic Radiosurgery: Multi-Institutional Study.
Bin-Alamer, Othman; Abou-Al-Shaar, Hussam; Mallela, Arka N; Kallos, Justiss A; Deng, Hansen; Nabeel, Ahmed M; Reda, Wael A; Tawadros, Sameh R; Abdelkarim, Khaled; El-Shehaby, Amr M N; Emad, Reem M; Peker, Selcuk; Samanci, Yavuz; Lee, Cheng-Chia; Yang, Huai-Che; Mathieu, David; Tripathi, Manjul; Mantziaris, Georgios; Mullapudi, Abhishek; Urgosik, Dusan; Liscak, Roman; Bowden, Greg N; Zaki, Peter; Wegner, Rodney E; Shepard, Matthew J; Sheehan, Jason P; Niranjan, Ajay; Hadjipanayis, Constantinos G; Lunsford, L Dade.
Afiliación
  • Bin-Alamer O; Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh , Pennsylvania , USA.
  • Abou-Al-Shaar H; Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh , Pennsylvania , USA.
  • Mallela AN; Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh , Pennsylvania , USA.
  • Kallos JA; Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh , Pennsylvania , USA.
  • Deng H; Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh , Pennsylvania , USA.
  • Nabeel AM; Gamma Knife Center Cairo, Nasser Institute Hospital, Cairo , Egypt.
  • Reda WA; Neurosurgery Department, Benha University, Qalubya , Egypt.
  • Tawadros SR; Gamma Knife Center Cairo, Nasser Institute Hospital, Cairo , Egypt.
  • Abdelkarim K; Neurosurgery Department, Ain Shams University, Cairo , Egypt.
  • El-Shehaby AMN; Gamma Knife Center Cairo, Nasser Institute Hospital, Cairo , Egypt.
  • Emad RM; Neurosurgery Department, Ain Shams University, Cairo , Egypt.
  • Peker S; Gamma Knife Center Cairo, Nasser Institute Hospital, Cairo , Egypt.
  • Samanci Y; Clinical Oncology Department, Ain Shams University, Cairo , Egypt.
  • Lee CC; Gamma Knife Center Cairo, Nasser Institute Hospital, Cairo , Egypt.
  • Yang HC; Neurosurgery Department, Ain Shams University, Cairo , Egypt.
  • Mathieu D; Gamma Knife Center Cairo, Nasser Institute Hospital, Cairo , Egypt.
  • Tripathi M; Radiation Oncology Department, National Cancer Institute, Cairo University, Cairo , Egypt.
  • Mantziaris G; Department of Neurosurgery, Koc University School of Medicine, Istanbul , Turkey.
  • Mullapudi A; Department of Neurosurgery, Koc University School of Medicine, Istanbul , Turkey.
  • Urgosik D; Department of Neurosurgery, Neurological Institute, Taipei Veteran General Hospital, Taipei , Taiwan.
  • Liscak R; School of Medicine, National Yang-Ming University, Taipei , Taiwan.
  • Bowden GN; Department of Neurosurgery, Neurological Institute, Taipei Veteran General Hospital, Taipei , Taiwan.
  • Zaki P; School of Medicine, National Yang-Ming University, Taipei , Taiwan.
  • Wegner RE; Department of Neurosurgery, Université de Sherbrooke, Centre de recherche du CHUS, Sherbrooke , Quebec , Canada.
  • Shepard MJ; Department of Neurosurgery, Post Graduate Institute of Medical Education and Research, Chandigarh , India.
  • Sheehan JP; Department of Neurological Surgery, University of Virginia, Charlottesville , Virginia , USA.
  • Niranjan A; Department of Neurological Surgery, University of Virginia, Charlottesville , Virginia , USA.
  • Hadjipanayis CG; Stereotactic and Radiation Neurosurgery, Na Homolce Hospital, Prague , Czech Republic.
  • Lunsford LD; Stereotactic and Radiation Neurosurgery, Na Homolce Hospital, Prague , Czech Republic.
Neurosurgery ; 94(2): 289-296, 2024 02 01.
Article en En | MEDLINE | ID: mdl-37581440
ABSTRACT
BACKGROUND AND

OBJECTIVES:

Intratumoral hemorrhage (ITH) in vestibular schwannoma (VS) after stereotactic radiosurgery (SRS) is exceedingly rare. The aim of this study was to define its incidence and describe its management and outcomes in this subset of patients.

METHODS:

A retrospective multi-institutional study was conducted, screening 9565 patients with VS managed with SRS at 10 centers affiliated with the International Radiosurgery Research Foundation.

RESULTS:

A total of 25 patients developed ITH (cumulative incidence of 0.26%) after SRS management, with a median ITH size of 1.2 cm 3 . Most of the patients had Koos grade II-IV VS, and the median age was 62 years. After ITH development, 21 patients were observed, 2 had urgent surgical intervention, and 2 were initially observed and had late resection because of delayed hemorrhagic expansion and/or clinical deterioration. The histopathology of the resected tumors showed typical, benign VS histology without sclerosis, along with chronic inflammatory cells and multiple fragments of hemorrhage. At the last follow-up, 17 patients improved and 8 remained clinically stable.

CONCLUSION:

ITH after SRS for VS is extremely rare but has various clinical manifestations and severity. The management paradigm should be individualized based on patient-specific factors, rapidity of clinical and/or radiographic progression, ITH expansion, and overall patient condition.
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Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Neuroma Acústico / Radiocirugia Límite: Humans / Middle aged Idioma: En Revista: Neurosurgery Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Bases de datos: MEDLINE Asunto principal: Neuroma Acústico / Radiocirugia Límite: Humans / Middle aged Idioma: En Revista: Neurosurgery Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos