Hemorrhage into Cystic Vestibular Schwannoma Following Stereotactic Radiation Therapy

Ganslandt, Oliver; Fahrig, Antje; Strauss, Catharina

doi:10.1055/s-2008-1077074

Cited by 26 publications

(28 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…lock 27 in 93%. The clinically relevant implication of this observation remains unclear, especially as Ganslandt et al, 10 for example, described that histopathological examination of a previously irradiated tumor with hemorrhage into cystic VS showed no radiotherapy-induced necrosis.…”

Section: Discussionmentioning

confidence: 93%

Magnetic resonance imaging dynamics of contrast medium uptake in vestibular schwannomas

Rampp

Scheller

Prell

et al. 2011

JNS

View full text Add to dashboard Cite

Contrast enhancement in VS MR imaging varies according to the duration of the delay between contrast agent administration and image acquisition. Postradiotherapy changes in contrast enhancement of VS can therefore not be attributed only to effective radiotherapy. So-called "loss of central contrast enhancement" may be falsely detected because of timing. A standardized protocol with defined timing of image acquisition may increase comparability of contrast uptake in VS.

show abstract

Section: Discussionmentioning

confidence: 93%

Magnetic resonance imaging dynamics of contrast medium uptake in vestibular schwannomas

Rampp

Scheller

Prell

et al. 2011

JNS

View full text Add to dashboard Cite

show abstract

“…In a report by Pendl et al, 19 radiosurgery outcomes were suboptimal, with 3 of 6 cystic tumors demonstrating rapid and significant cystic expansion requiring urgent surgery for neurological decline. Ganslandt et al 7 described an intratumoral hemorrhage leading to death in a patient with CVS 15 months after treatment with stereotactic radiosurgery. Delsanti and Régis 4 described their experience with stereotactic radiosurgery in the treatment of 54 CVS cases.…”

Section: Discussionmentioning

confidence: 99%

Extent of resection and early postoperative outcomes following removal of cystic vestibular schwannomas: surgical experience over a decade and review of the literature

Yashar

Zada²,

Harris³

et al. 2012

FOC

View full text Add to dashboard Cite

Object Vestibular schwannomas (VSs) are benign tumors of the eighth cranial nerve sheath, representing approximately 6%–8% of all newly diagnosed brain tumors, with an annual incidence of 2000–2500 cases in the US. Although most of these lesions are solid, cystic vestibular schwannomas (CVSs) compose 4%–20% of all VSs and are commonly larger at the time of presentation. The authors present their experience with the operative management of CVSs, including surgical approach, extent of resection, and postoperative facial nerve outcomes. The literature pertaining to clinical and histopathological differences between CVSs and their solid counterparts is reviewed. Methods The University of Southern California Department of Neurosurgery database was retrospectively reviewed to identify patients who had undergone resection of a VS between 2000 and 2010. One hundred seventy-nine patients with VS were identified. Patients with CVSs were the subject of the present analysis. Diagnosis of a CVS was made based on MRI findings. Clinical and neuroimaging data, including pre- and postoperative assessments and operative notes, were collected and reviewed. Results Twenty-three patients, 14 men (61%) and 9 women (39%), underwent 24 operations for CVSs. These patients composed 12.8% of all cases of VS. Patient ages ranged from 28 to 78 years (mean 55 years), and the mean maximal tumor diameter was 3.6 cm (range 2.0–4.0 cm). Patients most frequently presented with headache, hearing loss, vertigo, and dizziness. Preoperative facial numbness was reported in 44% of patients. Among the 24 cases, 13 were treated with retrosigmoid craniotomy and 11 via a translabyrinthine approach. Complete resection was achieved in 11 patients (48%), subtotal resection (STR) in 8 patients (35%), and near-total resection (NTR) in 4 patients (17%). Facial nerve outcomes were available in all except one case. Good facial nerve outcomes (House-Brackmann [HB] Grades I–III) were achieved in 82% of the patients who had undergone either NTR or STR, as compared with 73% of patients who had undergone gross-total resection (GTR; p > 0.05, Fisher exact test). In comparison, 83% of patients with solid VSs had a good HB grade (p = 0.38, Fisher exact test), although this finding did not reach statistical significance. Complications included wound infection (2 patients), delayed CSF leakage (1 patient), and a delayed temporal encephalocele following a translabyrinthine approach and requiring surgical repair (1 patient). Conclusions Cystic vestibular schwannoma represents a clinical and surgical entity separate from its solid counterpart, as demonstrated by its more rapid clinical course and early surgical outcomes. Facial nerve grades may correlate with the degree of tumor resection, trending toward poorer grades with more significant resections. Although GTR is recommended whenever possible, performing an STR when facial nerve preservation is in jeopardy to improve facial nerve outcomes is the preferred strategy at the authors' institution.

show abstract

“…VSs with fluid-fluid levels are not appropriate for 'watch and wait' treatment approaches due to the relatively high probability of sudden tumor enlargement due to hemorrhage (3,5,15). Furthermore, radiosurgery is not recommended, as the expansion of the cystic components and possible hemorrhage following radiosurgery may result in sudden deterioration (2, 16,17). Therefore, surgery is the optimal treatment strategy for such patients.…”

Section: A B C D E Discussionmentioning

confidence: 99%

Multicystic vestibular schwannomas with fluid-fluid levels: A report of three cases

Hao

et al. 2015

Oncology Letters

View full text Add to dashboard Cite

Abstract. The present study reported three rare cases of multicystic vestibular schwannoma with fluid-fluid levels. These three tumors exhibited apparent fluid-fluid levels that demonstrated a radiological appearance of two fluid levels in the cystic area. Two cases had an acute history, whereas one case presented with a chronic progression. A suboccipital retrosigmoid approach was used for access to the tumors and gross total resection was achieved in all the cases. During the surgical procedures, unclotted blood was observed, and the tumors were adhered to the facial nerve, other cranial nerves or the brain stem. In each case, the facial nerve function of the patients was impaired following surgery. The present study discussed the possible mechanism of the formation of the fluid-fluid levels, the effect of the fluid-fluid levels and the therapeutic strategy employed.

show abstract

Hemorrhage into Cystic Vestibular Schwannoma Following Stereotactic Radiation Therapy

Cited by 26 publications

References 10 publications

Magnetic resonance imaging dynamics of contrast medium uptake in vestibular schwannomas

Magnetic resonance imaging dynamics of contrast medium uptake in vestibular schwannomas

Extent of resection and early postoperative outcomes following removal of cystic vestibular schwannomas: surgical experience over a decade and review of the literature

Multicystic vestibular schwannomas with fluid-fluid levels: A report of three cases

Contact Info

Product

Resources

About