{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T16:08:10Z","timestamp":1776096490357,"version":"3.50.1"},"reference-count":34,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"8","license":[{"start":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T00:00:00Z","timestamp":1771804800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2026,2,23]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>For small- to medium-sized vestibular schwannomas, especially in patients with preserved hearing and no mass-effect symptoms, Gamma Knife radiosurgery (GKRS) is a preferred initial treatment. It provides effective tumor control and long-term hearing preservation. In the event of a tumor progression, reirradiation remains an option. A rare occurrence is the development of a second schwannoma along the same nerve. In such cases, repeat GKRS can be challenging, as it requires balancing local control with minimizing integral radiation dose and potential toxicity from reirradiation. The authors highlight the feasibility of repeat GKRS and the dosimetric considerations involved in radiating a second schwannoma along the same nerve.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 35-year-old woman with a history of headaches and a right-sided vestibular schwannoma underwent GKRS as treatment for the tumor. After being under surveillance from 2013 to 2025, the patient\u2019s vestibular schwannoma remained stable. After experiencing a worsening right-sided tinnitus, an updated MRI study revealed a new intracanalicular nodular formation along the nerve, which was treated with GKRS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>This case demonstrates the safety and efficacy of GKRS as a retreatment option in the rare occurrence of a second vestibular schwannoma developing along the same cranial nerve.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE25667\">https:\/\/thejns.org\/doi\/10.3171\/CASE25667<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case25667","type":"journal-article","created":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T11:47:19Z","timestamp":1771847239000},"source":"Crossref","is-referenced-by-count":0,"title":["Birds on a wire: Gamma Knife radiosurgery for two schwannomas along the same cranial nerve. Illustrative case"],"prefix":"10.3171","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7884-6394","authenticated-orcid":true,"given":"Neil D.","family":"Almeida","sequence":"first","affiliation":[{"name":"Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, Buffalo"},{"name":"Department of Radiation Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9746-7931","authenticated-orcid":true,"given":"Victor","family":"Goulenko","sequence":"additional","affiliation":[{"name":"Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, Buffalo"},{"name":"Department of Radiation Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-0219-3782","authenticated-orcid":true,"given":"Amanda","family":"Holowatyj","sequence":"additional","affiliation":[{"name":"Department of Radiation Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8084-3985","authenticated-orcid":true,"given":"Sarthak","family":"Sinha","sequence":"additional","affiliation":[{"name":"Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, Buffalo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2410-7588","authenticated-orcid":true,"given":"Shefalika","family":"Prasad","sequence":"additional","affiliation":[{"name":"Department of Neurology, Yale School of Medicine, New Haven, Connecticut"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6636-3996","authenticated-orcid":true,"given":"Harshini K.","family":"Cheruvu","sequence":"additional","affiliation":[{"name":"Department of Statistics & Data Science, Cornell University, Ithaca, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8120-3358","authenticated-orcid":true,"given":"Rohil","family":"Shekher","sequence":"additional","affiliation":[{"name":"Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, Buffalo"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0309-8130","authenticated-orcid":true,"given":"Robert A.","family":"Fenstermaker","sequence":"additional","affiliation":[{"name":"Department of Radiation Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, New York"},{"name":"Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo"},{"name":"Department of Neurosurgery, Roswell Park Comprehensive Cancer Center, Buffalo, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6615-4235","authenticated-orcid":true,"given":"Dheerendra","family":"Prasad","sequence":"additional","affiliation":[{"name":"Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, Buffalo"},{"name":"Department of Radiation Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, New York"},{"name":"Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo"},{"name":"Department of Neurosurgery, Roswell Park Comprehensive Cancer Center, Buffalo, New York"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"4","key":"bib1","series-title":"Head Neck Pathol","first-page":"1058","article-title":"Vestibular schwannoma: what we know and where we are heading","volume":"14","author":"Gupta","year":"2020","unstructured":"Gupta VKThakker AGupta KK.Vestibular schwannoma: what we know and where we are heading. Head Neck Pathol. 2020;14(4):1058-1066. doi:10.1007\/s12105-020-01155-x"},{"issue":"suppl","key":"bib2","series-title":"J Neurosurg","first-page":"123","article-title":"Gamma Knife radiosurgery for vestibular schwannoma: clinical results at long-term follow-up in a series of 379 patients","volume":"121","author":"Boari","year":"2014","unstructured":"Boari NBailo MGagliardi FGamma Knife radiosurgery for vestibular schwannoma: clinical results at long-term follow-up in a series of 379 patients. J Neurosurg. 2014;121(suppl):123-142. doi:10.3171\/2014.8.GKS141506"},{"issue":"11","key":"bib3","series-title":"Cureus","first-page":"e1846","article-title":"Signs and symptoms of acoustic neuroma at initial presentation: an exploratory analysis","volume":"9","author":"Foley","year":"2017","unstructured":"Foley RWShirazi SMaweni RMSigns and symptoms of acoustic neuroma at initial presentation: an exploratory analysis. Cureus. 2017;9(11):e1846. doi:10.7759\/cureus.1846"},{"key":"bib4","series-title":"Int J Surg Case Rep","first-page":"111291","article-title":"Unmasking vestibular schwannoma: a series of unusual cases","volume":"131","author":"Haider","year":"2025","unstructured":"Haider NRadi QAhmad SMohsen S.Unmasking vestibular schwannoma: a series of unusual cases. Int J Surg Case Rep. 2025;131:111291. doi:10.1016\/j.ijscr.2025.111291"},{"issue":"1","key":"bib5","series-title":"Neuro Oncol","first-page":"31","article-title":"EANO guideline on the diagnosis and treatment of vestibular schwannoma","volume":"22","author":"Goldbrunner","year":"2020","unstructured":"Goldbrunner RWeller MRegis JEANO guideline on the diagnosis and treatment of vestibular schwannoma. 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