{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T05:48:48Z","timestamp":1774676928145,"version":"3.50.1"},"reference-count":32,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>Stereotactic radiosurgery (SRS) is an accepted treatment option for patients with benign parasellar tumors. Here, the authors\u2019 objective was to determine the risk of developing new or progressive internal carotid artery (ICA) stenosis or occlusion after single-fraction SRS for cavernous sinus meningioma (CSM) or growth hormone\u2013secreting pituitary adenoma (GHPA).<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>The authors queried their prospectively maintained registry for patients treated with single-fraction SRS for CSM or GHPA in the period from 1990 to 2015. Study criteria included no prior irradiation and \u2265 12 months of post-SRS radiological follow-up. Pre-SRS grading of ICA involvement was applied according to the 1993 classification schemes of Hirsch for CSM or Knosp for GHPA.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>The authors conducted a retrospective review of 283 patients, 155 with CSMs and 128 with GHPAs. Ninety-three (60%) CSMs were Hirsch category 2 and 3 tumors; 97 (76%) GHPAs were Knosp grade 2\u20134 tumors. Median follow-up after SRS was 6.6 years (IQR 1\u201324.9 years). No GHPA or category 1 CSM developed ICA stenosis or occlusion. Three (5.2%) patients with category 2 CSMs had asymptomatic ICA stenosis (n = 2) or occlusion (n = 1); 1 (1.1%) category 2 CSM patient had transient ischemic symptoms. Five (14.3%) category 3 CSMs progressed to ICA occlusion (4 asymptomatic, 1 symptomatic). The median time to stenosis\/occlusion was 4.8 years (IQR 1.8\u20137.6). Five- and 10-year risks of ICA stenosis\/occlusion in category 2 and 3 CSM patients were 7.5% and 12.4%, respectively. Five- and 10-year risks of ischemic stroke from ICA stenosis\/occlusion in category 2 and 3 CSM patients were both 1.2%. Multivariate analysis showed patient age (HR 0.92, 95% CI 0.86\u20130.98, p = 0.01), meningioma pathology (HR and 95% CI not defined, p = 0.03), and pre-SRS carotid category (HR 4.51, 95% CI 1.77\u201314.61, p = 0.004) to be associated with ICA stenosis\/occlusion. Internal carotid artery stenosis\/occlusion was not related to post-SRS tumor growth (HR and 95% CI not defined, p = 0.41).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>New or progressive ICA stenosis\/occlusion was common after SRS for CSM but was not observed after SRS for GHPA, suggesting a tumor-specific mechanism unrelated to radiation dose. Pre-SRS ICA encasement or constriction increases the risk of ICA stenosis\/occlusion; however, the risk of ischemic complications is very low.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2019.8.jns191285","type":"journal-article","created":{"date-parts":[[2019,11,2]],"date-time":"2019-11-02T01:40:40Z","timestamp":1572658840000},"page":"1388-1395","source":"Crossref","is-referenced-by-count":14,"title":["Risk of internal carotid artery stenosis or occlusion after single-fraction radiosurgery for benign parasellar tumors"],"prefix":"10.3171","volume":"133","author":[{"given":"Christopher S.","family":"Graffeo","sequence":"first","affiliation":[{"name":"Departments of Neurologic Surgery,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael J.","family":"Link","sequence":"additional","affiliation":[{"name":"Departments of Neurologic Surgery,"},{"name":"Otolaryngology\u2013Head and Neck Surgery, and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott L.","family":"Stafford","sequence":"additional","affiliation":[{"name":"Radiation Oncology, Mayo Clinic, Rochester, Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ian F.","family":"Parney","sequence":"additional","affiliation":[{"name":"Departments of Neurologic Surgery,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert L.","family":"Foote","sequence":"additional","affiliation":[{"name":"Radiation Oncology, Mayo Clinic, Rochester, Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruce E.","family":"Pollock","sequence":"additional","affiliation":[{"name":"Departments of Neurologic Surgery,"},{"name":"Radiation Oncology, Mayo Clinic, Rochester, Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Stereotact Funct Neurosurg","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1159\/000107365","article-title":"Internal carotid occlusion following gamma knife radiosurgery for cavernous sinus meningioma","volume":"85","author":"Abeloos L","year":"2007","unstructured":"Abeloos L, Levivier M, Devriendt D, Massager N: Internal carotid occlusion following gamma knife radiosurgery for cavernous sinus meningioma. 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