• Junhyung Kim, Byungjun Woo, Soyoung Ji, Kihwan Hwang, KimYoung HoonYHDepartment of Neurosurgery, Asan Medical Center, Seoul, Republic of Korea., Jung Ho Han, and Chae-Yong Kim.
• Department of Neurosurgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea; Department of Neurosurgery, Asan Medical Center, Seoul, Republic of Korea.
• World Neurosurg. 2022 Sep 1; 165: e505e511e505-e511.

ObjectiveThis study aimed to clarify the risk of communicating hydrocephalus in cerebellopontine angle tumors, focusing on distinct tumor types and treatment modalities, i.e., tumor resection and stereotactic radiosurgery (SRS).MethodsThis study was a retrospective single-center cohort study. The cumulative incidences of symptomatic communicating hydrocephalus in schwannoma and meningioma patients were evaluated. A multivariate Cox model was used to assess the hazard ratios for the risk factors and odds ratios of distinct treatment subgroups.ResultsA total of 405 cases, including 286 schwannomas and 119 meningiomas, were retrospectively reviewed. The risk of hydrocephalus was significantly higher in schwannomas than that in meningiomas (hazard ratio, 4.70 [95% confidence interval, 1.78-12.4, P = 0.002]). Patients with schwannomas who received SRS without tumor resection showed a significantly higher incidence than meningioma cases: 10.6% versus 1.4% (P = 0.037). We identified specific subgroups that were prone to increase the risk of hydrocephalus when treated with SRS alone. The result showed that patients with vestibular schwannoma of Koos grade III had a greater benefit from tumor resection than from SRS in preventing hydrocephalus (odds ratio, 0.089 [95% confidence interval, 0.011-0.743, P = 0.025]).ConclusionsSymptomatic communicating hydrocephalus is more frequent in schwannoma than that in meningiomas. Primary treatment with tumor resection lowers the risk of hydrocephalus in specific subgroups of vestibular schwannoma.Copyright © 2022 Elsevier Inc. All rights reserved.

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