{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T22:31:39Z","timestamp":1790721099290,"version":"4.1.0"},"reference-count":30,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2011,5]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>The current, generally accepted optimal management for hydrocephalus related to vestibular schwannomas (VSs) is primary tumor removal, with further treatment reserved only for patients who remain symptomatic. Previous studies have shown, however, that this management can lead to an increase in surgery-related complications. In this study, the authors evaluated their experience with the treatment of such patients, with the aim of identifying the following: 1) the parameters correlating to the need for specific hydrocephalus treatment following VS surgery; and 2) patients at risk for developing hydrocephalus-related complications.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>This was a retrospective study of a 400-patient series. The complication rates and outcomes following primary hydrocephalus treatment versus primary VS removal were compared. Patients undergoing primary tumor removal were further subdivided on the basis of the need for subsequent hydrocephalus treatment. The 3 categories of parameters tested for correlation with the need for such subsequent treatment as well as with heightened risk for developing complications were patient-, tumor-, and hydrocephalus-related.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Of the entire series, 53 patients presented with hydrocephalus. Forty-eight of 53 patients underwent primary VS surgery, of whom 42 (87.5%) did not require additional hydrocephalus treatment. Of the 6 patients who did require additional hydrocephalus treatment, only 3 ultimately required a VP shunt. Factors correlating to the need of hydrocephalus treatment after VS removal were large tumor size, irregular tumor surface, and severe preoperative hydrocephalus. Patients with a longer symptom duration prior to surgery, those with polycyclic tumors, or with inhomogeneous VS, were at heightened risk for the development of CSF leaks. The general and functional outcome of surgery showed no correlation to the presence of preoperative hydrocephalus.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Primary tumor removal is the optimum management of disease in patients with VS with associated hydrocephalus; it leads to resolution of the hydrocephalus in the majority of cases, and the outcome is similar to that of patients without hydrocephalus. Certain factors may aid in identifying patients at risk for developing persistent hydrocephalus as well as those at risk for CSF leaks.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2010.10.jns1029","type":"journal-article","created":{"date-parts":[[2010,12,10]],"date-time":"2010-12-10T14:57:14Z","timestamp":1291993034000},"page":"1209-1215","source":"Crossref","is-referenced-by-count":45,"title":["Hydrocephalus associated with vestibular schwannomas: management options and factors predicting the outcome"],"prefix":"10.3171","volume":"114","author":[{"given":"Venelin M.","family":"Gerganov","sequence":"first","affiliation":[{"name":"International Neuroscience Institute, Hannover, Germany; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariyan","family":"Pirayesh","sequence":"additional","affiliation":[{"name":"International Neuroscience Institute, Hannover, Germany; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohsen","family":"Nouri","sequence":"additional","affiliation":[{"name":"International Neuroscience Institute, Hannover, Germany; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nirjhar","family":"Hore","sequence":"additional","affiliation":[{"name":"International Neuroscience Institute, Hannover, Germany; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wolf O.","family":"Luedemann","sequence":"additional","affiliation":[{"name":"International Neuroscience Institute, Hannover, Germany; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shizuo","family":"Oi","sequence":"additional","affiliation":[{"name":"International Neuroscience Institute, Hannover, Germany; and"},{"name":"Division of Pediatric Neurosurgery, Women's and Children's Medical Center, Jikei University Hospital, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir","family":"Samii","sequence":"additional","affiliation":[{"name":"International Neuroscience Institute, Hannover, Germany; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madjid","family":"Samii","sequence":"additional","affiliation":[{"name":"International Neuroscience Institute, Hannover, Germany; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns1029","series-title":"Laryngoscope","first-page":"204","article-title":"Evolution of the management of hydrocephalus associated with acoustic neuroma","volume":"106","author":"Atlas","year":"1996"},{"key":"b2-jns1029","series-title":"Acta Neurochir (Wien)","first-page":"979","article-title":"Incidence of cerebrospinal fluid leak after microsurgical removal of vestibular schwannomas","volume":"144","author":"Bani","year":"2002"},{"key":"b3-jns1029","series-title":"Otol Neurotol","first-page":"107","article-title":"Cerebrospinal fluid leak after acoustic neuroma surgery: a comparison of the translabyrinthine, middle fossa, and retrosigmoid approaches","volume":"24","author":"Becker","year":"2003"},{"key":"b4-jns1029","series-title":"Acta Neurochir (Wien)","first-page":"73","article-title":"Non-obstructive hydrocephalus associated with intracranial schwannomas: hyperproteinorrhachia as an etiopathological factor?","volume":"145","author":"Bloch","year":"2003"},{"key":"b5-jns1029","series-title":"J Clin Neurosci","first-page":"521","article-title":"Current management of acoustic neuromas: review of surgical approaches and outcomes","volume":"7","author":"Briggs","year":"2000"},{"key":"b6-jns1029","series-title":"Otolaryngol Head Neck Surg","first-page":"1020","article-title":"Management of hydrocephalus resulting from acoustic neuromas","volume":"109","author":"Briggs","year":"1993"},{"key":"b7-jns1029","series-title":"Otolaryngol Head Neck Surg","first-page":"81","article-title":"Cerebrospinal fluid leaks and meningitis in acoustic neuroma surgery","volume":"104","author":"Bryce","year":"1991"},{"key":"b8-jns1029","series-title":"J Neurosurg","first-page":"480","article-title":"Hydrocephalus associated with intramedullary low-grade glioma. Illustrative cases and review of the literature","volume":"83","author":"Cinalli","year":"1995"},{"key":"b9-jns1029","series-title":"Laryngoscope","first-page":"501","article-title":"Prevention and management of cerebrospinal fluid leak following vestibular schwannoma surgery","volume":"114","author":"Fishman","year":"2004"},{"key":"b10-jns1029","series-title":"Neurosurgery","first-page":"1186","article-title":"Etiopathological factors related to hydrocephalus associated with vestibular schwannoma","volume":"61","author":"Fukuda","year":"2007"},{"key":"b11-jns1029","series-title":"N Engl J Med","first-page":"932","article-title":"Increased intracranial pressure caused by increased protein content in the cerebrospinal fluid; an explanation of papilledema in certain cases of small intracranial and intraspinal tumors, and in the Guillain-Barre syndrome","volume":"250","author":"Gardner","year":"1954"},{"key":"b12-jns1029","series-title":"Acta Neurochir (Wien)","first-page":"581","article-title":"Prognostic clinical and radiological parameters for immediate facial nerve function following vestibular schwannoma surgery","volume":"151","author":"Gerganov","year":"2009"},{"key":"b13-jns1029","series-title":"Acta Neurochir (Wien)","first-page":"1147","article-title":"The role of endoscopic third ventriculostomy in the management of hydrocephalus associated with cerebellopontine angle tumours","volume":"148","author":"Hayhurst","year":"2006"},{"key":"b14-jns1029","series-title":"Otolaryngol Head Neck Surg","first-page":"146","article-title":"Facial nerve grading system","volume":"93","author":"House","year":"1985"},{"key":"b15-jns1029","series-title":"Otol Neurotol","first-page":"642","article-title":"New and modified reporting systems from the consensus meeting on systems for reporting results in vestibular schwannoma","volume":"24","author":"Kanzaki","year":"2003"},{"key":"b16-jns1029","series-title":"Neurosurgery","first-page":"726","article-title":"Intraspinal tumors associated with hydrocephalus","volume":"21","author":"Kudo","year":"1987"},{"key":"b17-jns1029","series-title":"J Neurosurg","first-page":"80","article-title":"Human arachnoid villi response to subarachnoid hemorrhage: possible relationship to chronic hydrocephalus","volume":"91","author":"Massicotte","year":"1999"},{"key":"b18-jns1029","series-title":"Neurosurgery","first-page":"1","article-title":"Management of 1000 vestibular schwannomas (acoustic neuromas): clinical presentation","volume":"40","author":"Matthies","year":"1997"},{"key":"b19-jns1029","series-title":"Neurosurgery","first-page":"1246","article-title":"Management of hydrocephalus associated with vestibular schwannoma and other cerebellopontine angle tumors","volume":"48","author":"Pirouzmand","year":"2001"},{"key":"b20-jns1029","series-title":"Neuroradiology","first-page":"344","article-title":"Prevalence of hydrocephalus in 157 patients with vestibular schwannoma","volume":"47","author":"Rogg","year":"2005"},{"key":"b21-jns1029","series-title":"J Neurosurg","first-page":"527","article-title":"Improved preservation of hearing and facial nerve function in vestibular schwannoma surgery via the retrosigmoid approach in a series of 200 patients","volume":"105","author":"Samii","year":"2006"},{"key":"b22-jns1029","series-title":"Neurosurgery","first-page":"248","article-title":"Management of 1000 vestibular schwannomas (acoustic neuromas): hearing function in 1000 tumor resections","volume":"40","author":"Samii","year":"1997"},{"key":"b23-jns1029","series-title":"Neurosurgery","first-page":"11","article-title":"Management of 1000 vestibular schwannomas (acoustic neuromas): surgical management and results with an emphasis on complications and how to avoid them","volume":"40","author":"Samii","year":"1997"},{"key":"b24-jns1029","series-title":"Neurosurgery","first-page":"684","article-title":"Management of 1000 vestibular schwannomas (acoustic neuromas): the facial nerve\u2014preservation and restitution of function","volume":"40","author":"Samii","year":"1997"},{"key":"b25-jns1029","series-title":"Otol Neurotol","first-page":"379","article-title":"Perioperative complications in acoustic neuroma (vestibular schwannoma) surgery","volume":"25","author":"Sanna","year":"2004"},{"key":"b26-jns1029","series-title":"Otol Neurotol","first-page":"895","article-title":"Perioperative morbidity of acoustic neuroma surgery","volume":"22","author":"Slattery","year":"2001"},{"key":"b27-jns1029","series-title":"Otolaryngol Head Neck Surg","first-page":"35","article-title":"Hydrocephalus in the patient with acoustic neuroma","volume":"107","author":"Steenerson","year":"1992"},{"key":"b28-jns1029","series-title":"J Neurosurg","first-page":"874","article-title":"Factors affecting postoperative cerebrospinal fluid leaks after retrosigmoidal craniotomy for vestibular schwannomas. 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