{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T10:25:15Z","timestamp":1794219915134,"version":"4.8.0"},"reference-count":44,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Communicating hydrocephalus may occur following stereotactic radiosurgery (SRS) for vestibular schwannomas (VSs), yet identifying individual patient risk factors associated with this post-SRS complication remains a challenge. This study examined predictors of nonobstructive ventricular enlargement and symptomatic communicating hydrocephalus following primary SRS treatment for VS via a single-center institutional cohort review and meta-analysis of the literature.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>A retrospective single-institution cohort study and systematic literature review and meta-analysis examining post-SRS communicating hydrocephalus in VS was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      The institutional cohort consisted of 634 patients who received primary SRS as treatment for VS. The cohort was 51.6% female, with a median age of 64 (range 18\u201389) years. Following SRS treatment, 364 patients (57.4%) experienced tumor shrinkage, 218 (34.4%) had no change in the size of their lesion, and 52 (8.2%) experienced tumor growth. Nonobstructive ventricular enlargement was observed in 23 patients (3.6%) following SRS treatment, of whom 9 (39.1%) remained asymptomatic and 14 (60.9%) required placement of a ventriculoperitoneal (VP) shunt, with a median time to shunt placement of 8 months. In the multivariate analysis, patients \u2265 65 years old (p = 0.038), SRS target volume \u2265 5 cm\n                      <jats:sup>3<\/jats:sup>\n                      (p &lt; 0.001), maximum SRS dose \u2265 26 Gy (p = 0.015), and tumor growth at the most recent follow-up (p = 0.002) were associated with an increased risk of post-SRS ventricular enlargement. Similarly, patients with older age (p = 0.049), increased SRS target volume (p = 0.002), and tumor growth (p = 0.016) were at an increased risk of symptomatic communicating hydrocephalus requiring VP shunt placement. Twenty-nine studies, including the cohort in this study, met inclusion criteria in the meta-analysis. Of the pooled 7825 patients, the overall incidence of hydrocephalus following SRS was 5%, and a subanalysis of 7081 patients demonstrated the incidence of symptomatic hydrocephalus requiring a VP shunt to be 4%. In this subanalysis, the overall shunting rate in patients who experienced post-SRS ventriculomegaly was 92%. Among individual studies in the literature, increased tumor size was most commonly found to be a statistically significant risk factor for post-SRS hydrocephalus.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Approximately 5% of patients may experience nonobstructive ventricular enlargement following primary SRS treatment for VS. However, not all patients may be symptomatic and require shunting. Patients who are older (\u2265 65 years), those with larger tumor volumes, and those with post-SRS tumor growth may be at increased risk of communicating hydrocephalus and may benefit from closer clinical monitoring.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2025.12.jns25176","type":"journal-article","created":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T01:52:37Z","timestamp":1778291557000},"page":"743-754","source":"Crossref","is-referenced-by-count":0,"title":["Risks associated with ventriculomegaly and symptomatic communicating hydrocephalus following stereotactic radiosurgery for vestibular schwannoma"],"prefix":"10.3171","volume":"145","author":[{"given":"Megan M. J.","family":"Bauman","sequence":"first","affiliation":[{"name":"Taylor Family Department of Neurosurgery, Washington University School of Medicine, St. Louis, Missouri"},{"name":"Department of Neurological Surgery, Mayo Clinic, Rochester;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha M.","family":"Bouchal","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Mayo Clinic, Rochester;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramin A.","family":"Morshed","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Mayo Clinic, Rochester;"},{"name":"Department of Neurological Surgery, University of California, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie J.","family":"Van Gompel","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Mayo Clinic, Rochester;"},{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Mayo Clinic, Rochester;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Peris Celda","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Mayo Clinic, Rochester;"},{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Mayo Clinic, Rochester;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul D.","family":"Brown","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce E.","family":"Pollock","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Mayo Clinic, Rochester;"},{"name":"Department of Radiation Oncology, Mayo Clinic, Rochester, Minnesota; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Link","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Mayo Clinic, Rochester;"},{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, Mayo Clinic, Rochester;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"2","key":"b1","series-title":"Otolaryngol Head Neck Surg","first-page":"209","article-title":"Global incidence of sporadic vestibular schwannoma: a systematic review","volume":"167","author":"Marinelli JP","year":"2022","unstructured":"Marinelli JP, Beeler CJ, Carlson ML, Caye-Thomasen P, Spear SA, Erbele ID. 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