Journal article
Intratumoral Hemorrhage in Vestibular Schwannomas After Stereotactic Radiosurgery: Multi-Institutional Study
Neurosurgery, v 94(2), pp 289-296
01 Feb 2024
PMID: 37581440
Featured in Collection : UN Sustainable Development Goals @ Drexel
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.
Metrics
1 Record Views
Details
- Title
- Intratumoral Hemorrhage in Vestibular Schwannomas After Stereotactic Radiosurgery: Multi-Institutional Study
- Creators
- Othman Bin-Alamer - University of Pittsburgh Medical CenterHussam Abou-Al-Shaar - University of Pittsburgh Medical CenterArka N. Mallela - University of Pittsburgh Medical CenterJustiss A. Kallos - Neurological SurgeryHansen Deng - University of Pittsburgh Medical CenterAhmed M. Nabeel - Nasser Institute hospitalWael A. Reda - Ain Shams UniversitySameh R. Tawadros - Ain Shams UniversityKhaled Abdelkarim - Ain Shams UniversityAmr M. N. El-Shehaby - Ain Shams UniversityReem M. Emad - Cairo UniversitySelcuk Peker - Koç UniversityYavuz Samanci - Koç UniversityCheng-chia Lee - National Yang Ming Chiao Tung UniversityHuai-che Yang - Taipei Veteran Gen Hosp, Neurol Inst, Dept Neurosurg, Taipei, TaiwanDavid Mathieu - Université de SherbrookeManjul Tripathi - Post Graduate Institute of Medical Education and ResearchGeorgios Mantziaris - Neurological SurgeryAbhishek Mullapudi - University of VirginiaDusan Urgosik - Na Homolce HospitalRoman Liscak - Na Homolce HospitalGreg N. Bowden - University of AlbertaPeter Zaki - Allegheny Health NetworkRodney E. Wegner - Allegheny Health NetworkMatthew J. Shepard - Allegheny Health NetworkJason P. Sheehan - Neurological SurgeryAjay Niranjan - University of Pittsburgh Medical CenterConstantinos G. Hadjipanayis - University of Pittsburgh Medical CenterL. Dade Lunsford - Neurological Surgery
- Publication Details
- Neurosurgery, v 94(2), pp 289-296
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 8
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Neurology
- Web of Science ID
- WOS:001444852600005
- Scopus ID
- 2-s2.0-85182728012
- Other Identifier
- 991022155294304721
UN Sustainable Development Goals (SDGs)
This publication has contributed to the advancement of the following goals:
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Clinical Neurology
- Surgery