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High incidence of transient perifocal edema following upfront radiosurgery for intraventricular meningiomas

  • Original Article - Brain Tumors
  • Published:
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Abstract

Introduction

Intraventricular trigonal meningiomas (ITM) seem to have a tendency for extensive perifocal edema formation following radiosurgery (RS). To further investigate this hypothesis, we undertook the following study.

Methods

We retrospectively reviewed records of patients who underwent RS for intraventricular meningiomas at our institution.

Results

From 1999 until 2019, 5 patients underwent single-session RS as primary treatment for ITM. Patients were treated either with a Gamma Knife or a CyberKnife. The mean prescription dose (PD) was 13.0 Gy ± 0.9, the mean tumor volume was 5.8 cc ± 3.1, and the mean follow-up (FU) was 8.9 years ± 5.6. Perifocal edema developed in 4/5 patients after a mean interval of 6.4 months ± 1.2. It was symptomatic in 2/5 patients. The edema regressed spontaneously in 4/5 patients. One of the patients underwent RS for the same ITM twice. One patient’s edema was treated medically with steroids, and none of the patients underwent surgery following RS.

Conclusion

Even though the number of patients is low, there seems to be a comparably high risk for the formation of a perifocal edema following RS for ITM. Single-session RS as primary treatment for ITM seems to be safe and effective even though a perifocal edema is likely to develop. The perifocal edema and the ensuing neurological deficits were transient and could be managed conservatively in all of our 5 cases.

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Author information

Authors and Affiliations

  1. Neurosurgery, Klinik Im Park, Seestrasse 220, 8027, Zurich, Switzerland

    Thomas Mindermann

  2. Neuroradiology, Klinik Im Park, Zurich, Switzerland

    Stefan Heckl

  3. Medical Physics, Klinik Hirslanden, Zurich, Switzerland

    Andreas Mack

Authors
  1. Thomas Mindermann
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  2. Stefan Heckl
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  3. Andreas Mack
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Corresponding author

Correspondence to Thomas Mindermann.

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Conflict of interest

All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (Kantonale Ethikkommission Zürich) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent or formal ethical approval is not required.

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This article is part of the Topical Collection on Brain Tumors

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Mindermann, T., Heckl, S. & Mack, A. High incidence of transient perifocal edema following upfront radiosurgery for intraventricular meningiomas. Acta Neurochir 162, 2177–2182 (2020). https://doi.org/10.1007/s00701-020-04281-1

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  • DOI: https://doi.org/10.1007/s00701-020-04281-1

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