{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T14:46:25Z","timestamp":1787496385162,"version":"build-2736575974"},"reference-count":28,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2016,4]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECT<\/jats:title>\n                    <jats:p>Peritumoral cysts are frequently associated with CNS hemangioblastomas and often underlie neurological morbidity and mortality. To determine their natural history and clinical impact, the authors prospectively analyzed hemangioblastoma-associated peritumoral cysts in patients with von Hippel-Lindau (VHL) disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Patients with VHL disease who had 2 or more years of follow-up and who were enrolled in a prospective study at the National Institutes of Health were included. Serial prospectively acquired laboratory, genetic, imaging, and clinical data were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>One hundred thirty-two patients (of 225 in the VHL study with at least 2 years of follow-up) had peritumoral cysts that were followed for more than 2 years (total of 292 CNS peritumoral cysts). The mean age at study entrance was 37.4 \u00b1 13.1 years ([mean \u00b1 SD], median 37.9, range 12.3\u201365.1 years). The mean follow-up was 7.0 \u00b1 1.7 years (median 7.3, range 2.1\u20139.0 years). Over the study period, 121 of the 292 peritumoral cysts (41.4%) became symptomatic. Development of new cysts was associated with a larger number cysts at study enrollment (p = 0.002) and younger age (p &lt; 0.0001). Cyst growth rate was associated with anatomical location (cerebellum cysts grew faster than spine and brainstem cysts; p = 0.0002 and p = 0.0008), younger age (&lt; 35 years of age; p = 0.0006), and development of new neurological symptoms (p &lt; 0.0001). Cyst size at symptom production depended on anatomical location (p &lt; 0.0001; largest to smallest were found, successively, in the cerebellum, spinal cord, and brainstem). The most common location for peritumoral cysts was the cerebellum (184 cysts [63%]; p &lt; 0.0001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>\n                      Peritumoral cysts frequently underlie symptom formation that requires surgical intervention in patients with VHL disease. Development of new cysts was associated with a larger number of cysts at study enrollment and younger age. Total peritumoral cyst burden was associated with germline partial deletion of the\n                      <jats:italic>VHL<\/jats:italic>\n                      gene.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2015.4.jns1533","type":"journal-article","created":{"date-parts":[[2015,10,30]],"date-time":"2015-10-30T10:03:06Z","timestamp":1446199386000},"page":"971-976","source":"Crossref","is-referenced-by-count":43,"title":["Biological and clinical impact of hemangioblastoma-associated peritumoral cysts in von Hippel-Lindau disease"],"prefix":"10.3171","volume":"124","author":[{"given":"Kristin","family":"Huntoon","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio;"},{"name":"Surgical Neurology Branch and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianxia","family":"Wu","sequence":"additional","affiliation":[{"name":"Office of the Clinical Director, National Institute of Neurological Disorders and Stroke;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Bradley","family":"Elder","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John A.","family":"Butman","sequence":"additional","affiliation":[{"name":"Neuroradiology Section, Diagnostic Radiology, Clinical Center at the National Institutes of Health;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily Y.","family":"Chew","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Clinical Applications, National Eye Institute;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. 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