title: Communicating Hydrocephalus Associated with Intracranial Schwannoma Treated by Gamma Knife Radiosurgery.
abstract: OBJECTIVE
  Gamma knife radiosurgery (GKRS) has been established as an effective and safe treatment for intracranial schwannoma. However, serious complications can occur after GKRS, including hydrocephalus. The pathophysiology and risk factors of this disorder are not yet fully understood. The objective of the study was to assess potential risk factors for hydrocephalus after GKRS.
  
  
  METHODS
  We retrospectively reviewed the medical radiosurgical records of 244 patients who underwent GKRS to treat intracranial schwannoma. The following parameters were analyzed as potential risk factors for hydrocephalus after GKRS: age, sex, target volume, irradiation dose, prior tumor resection, treatment technique, and tumor enhancement pattern. The tumor enhancement pattern was divided into 2 groups: group A (homogeneous enhancement) and group B (heterogeneous or rim enhancement).
  
  
  RESULTS
  Of the 244 patients, 14 of them (5.7%) developed communicating hydrocephalus. Communicating hydrocephalus occurred within 2 years after GKRS in most patients (92.8%). No significant association was observed between any of the parameters investigated and the development of hydrocephalus, with the exception of tumor enhancement pattern. Group B exhibited a statistically significant difference by univariate analysis (P = 0.002); this difference was also significant by multivariate analysis (P = 0.006).
  
  
  CONCLUSIONS
  Because hydrocephalus is curable, patients should be closely monitored for the development of this disorder after GKRS. In particular, patients with intracranial schwannomas with irregular enhancement patterns or cysts should be meticulously observed.
authors.affiliation: Department of Neurosurgery, College of Medicine, Kyung Hee University, Seoul, Korea.
authors.forename: Chang Kyu
authors.initials: CK
authors.lastname: Park
authors.affiliation: Department of Neurosurgery, College of Medicine, Kyung Hee University, Seoul, Korea.
authors.forename: Sung Ho
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Neurosurgery, College of Medicine, Kyung Hee University, Seoul, Korea.
authors.forename: Man Kyu
authors.initials: MK
authors.lastname: Choi
authors.affiliation: Department of Neurosurgery, College of Medicine, Kyung Hee University, Seoul, Korea.
authors.forename: Seok Keun
authors.initials: SK
authors.lastname: Choi
authors.affiliation: Department of Neurosurgery, College of Medicine, Kyung Hee University, Seoul, Korea.
authors.forename: Bong Jin
authors.initials: BJ
authors.lastname: Park
authors.affiliation: Department of Neurosurgery, College of Medicine, Kyung Hee University, Seoul, Korea. Electronic address: youngjinns@gmail.com.
authors.forename: Young Jin
authors.initials: YJ
authors.lastname: Lim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000150:complications / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000150:complications / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009442:Neurilemmoma / Q000150:complications / Q000000981:diagnostic imaging / Q000532:radiotherapy*; D016634:Radiosurgery / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: Complication; Gamma knife radiosurgery; Hydrocephalus; Schwannoma