Etiopathological Factors Related to Hydrocephalus Associated With Vestibular Schwannoma

Fukuda, Masafumi; Oishi, Makoto; Kawaguchi, Tadashi; Watanabe, Masatoshi; Takao, Tetsuro; Tanaka, Ryuichi; Fujii, Yukihiko

doi:10.1227/01.neu.0000306096.61012.22

Cited by 40 publications

(35 citation statements)

References 16 publications

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“…The probability for development of hydrocephalus depends on tumor size (>4 cm diameter) and development of hyper proteinorachia [2]. We believe that investigated patient developed hydrocephalus due to hyper proteinorachia and not due to presence of the tumor since schwannoma was small about 1.5 cm diameter.…”

Section: Discussionmentioning

confidence: 78%

“…According to literature normal pressure hydrocephalus respectively hydrocephalus malresorptivus occurs in 2 to 10 % of patients with schwannoma at the cerebellopontine angle [1,2]. The probability for development of hydrocephalus depends on tumor size (>4 cm diameter) and development of hyper proteinorachia [2].…”

Section: Discussionmentioning

confidence: 99%

“…It has been reported that schwannomas, meningiomas and cavernous hemangioma can produce hydrocephalus malresorptivus due to hyper proteinorachia and obstruction of pacchionian granulation [1,2].…”

Section: Introductionmentioning

confidence: 99%

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Normal Pressure Hydrocephalus, Dementia and Kynurenic Acid

Kepplinger¹,

Reuss²,

Sedlnitzky-Semler³

et al. 2017

Int J Neurorehabilitation Eng

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A female 49 years old patient with vestibular schwannoma developed normal pressure hydrocephalus. Patient complained about gait disturbance, urinary incontinence and memory impairment. Investigation of clinical parameter and measurement of kynurenic acid in the cerebrospinal fluid (CSF) and serum in patients with normal pressure hydrocephalus and in corresponding controls (CO; N=15) were performed. Within investigated parameters significant increase of protein and IgG levels in CSF were found in patient with normal pressure hydrocephalus. Furthermore, kynurenic acid was increased in the CSF by 60% and in the serum by 40%, comparing to CO subjects. Kynurenic acid level in CO was in the CSF and serum 2.77 ± 0.23 and 53.4 ± 4.0 nM, respectively. Three lumbar punctures were applied to patient with normal pressure hydrocephalus and clinical parameters partially normalized and lowering of kynurenic acid levels in CSF and serum were observed. Patient was improving after each lumbar puncture but the effect was transient, therefore permanent CSF shunting was recommended. After that a complete remission of symptoms occurred. Revealed data indicate a significant advantage of single punctures in management of treatment for normal pressure hydrocephalus. Increase of kynurenic acid in CSF represents interesting parameter. It is questionable if occurrence of cognition impairment and/or dementia in patients with normal pressure hydrocephalus might be related to an enhancement of kynurenic acid in the CNS.

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Normal Pressure Hydrocephalus, Dementia and Kynurenic Acid

Kepplinger¹,

Reuss²,

Sedlnitzky-Semler³

et al. 2017

Int J Neurorehabilitation Eng

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“…It has been reported that both gamma knife radiosurgery and microsurgery can contribute to the development or aggravation of hydrocephalus (Fukuda et al, 2007;Roche et al, 2008). However, the mechanism that is associated with the development of hydrocephalus following gamma knife radiosurgery is not known.…”

Section: Discussion Regarding the Development Of Hydrocephalus In Patmentioning

confidence: 99%

“…Several authors have reported treatment strategies for hydrocephalus before microsurgery or gamma knife radiosurgery (Atlas, et al, 1996;Fukuda, et al, 2007;Roche, et al, 2008). With respect to microsurgery, several investigators preferred a wait-and-see-approach and therefore focused only on the surgery for the tumour.…”

Section: Discussion Regarding the Development Of Hydrocephalus In Patmentioning

confidence: 99%

Gamma Knife Radiosurgery for the Vestibular Schwannomas, Technical Considerations and Hydrocephalus as a Complication

Hwang¹,

Park²,

Lee³

et al. 2011

Gamma Knife Radiosurgery

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Analysis of risk factors to predict communicating hydrocephalus following gamma knife radiosurgery for intracranial schwannoma

et al. 2016

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Communicating hydrocephalus (HCP) in vestibular schwannomas (VS) after gamma knife radiosurgery (GKRS) has been reported in the literature. However, little information about its incidence and risk factors after GKRS for intracranial schwannomas is yet available. The objective of this study was to identify the incidence and risk factors for developing communicating HCP after GKRS for intracranial schwannomas. We retrospectively reviewed a total of 702 patients with intracranial schwannomas who were treated with GKRS between January 2002 and December 2015. We investigated patients’ age, gender, tumor origin, previous surgery history, tumor volume, marginal radiation dose, and presence of tumor control to identify associations with communicating HCP following GKRS. To make predictive models of communicating HCP, we performed Cox regression analyses and constructed a decision tree for risk factors. In total, 29 of the 702 patients (4.1%) developed communicating HCP following GKRS, which required ventriculo‐peritoneal (VP) shunt surgery. Multivariate analyses indicated that age (P = 0.0011), tumor origin (P = 0.0438), and tumor volume (P < 0.0001) were significant predictors of communicating HCP in patients with intracranial schwannoma after GKRS. Using machine‐learning methods, we fit an optimal predictive model. We found that developing communicating HCP following GKRS was most likely if the tumor was vestibular origin and had a volume ≥13.65 cm3. Communicating HCP is not a rare complication of GKRS for intracranial schwannomas. Under specific conditions, communicating HCP following GKRS is warranted for this patient group, and this patient group should be closely followed up.

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Etiopathological Factors Related to Hydrocephalus Associated With Vestibular Schwannoma

Cited by 40 publications

References 16 publications

Normal Pressure Hydrocephalus, Dementia and Kynurenic Acid

Normal Pressure Hydrocephalus, Dementia and Kynurenic Acid

Gamma Knife Radiosurgery for the Vestibular Schwannomas, Technical Considerations and Hydrocephalus as a Complication

Analysis of risk factors to predict communicating hydrocephalus following gamma knife radiosurgery for intracranial schwannoma

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