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01-06-2022 | Vestibular Schwannoma | Review

The prognosis and treatment effectiveness of de novo aneurysm formation after radiation therapy for brain tumor

Authors: Satoshi Shinoda, Shinsuke Muraoka, Hiroyuki Shimizu, Naoki Koketsu, Yoshio Araki, Ryuta Saito

Published in: Neurosurgical Review | Issue 5/2022

Abstract

Radiation therapy is a well-established, minimally invasive method of treating brain tumors. In recent years, the number of post-radiotherapy patients has increased, and delayed side effects are evident. De novo aneurysm formation after radiation often manifests as fatal subarachnoid hemorrhage (SAH), resulting in severe clinical outcomes. Nevertheless, the prognosis and therapeutic efficacy of radiation-induced aneurysms (RIAs) remain unclear. Using the PubMed database from 1980 to 2021, we screened 45 articles (53 individual cases) on RIAs; approximately 70% of RIAs were diagnosed after rupture. Of 38 ruptured RIAs, 12 (31.6%) had modified Rankin scale (mRS) 5–6. On the other hand, all unruptured RIAs (15 cases) recovered without neurological deficits (p = 0.012). Ten of the 39 ruptured RIAs were treated surgically, and 22 were treated endovascularly. There was no significant difference in mRS between treatment modalities (p = 0.393), but conservative therapy was significantly related to unfavorable outcomes (p = 0.025). To improve clinical outcomes, RIAs need to be diagnosed before rupture. Surgeons should be aware of de novo aneurysm formation in patients long after radiation therapy.

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Title: The prognosis and treatment effectiveness of de novo aneurysm formation after radiation therapy for brain tumor
Authors: Satoshi Shinoda
Shinsuke Muraoka
Hiroyuki Shimizu
Naoki Koketsu
Yoshio Araki
Ryuta Saito
Publication date: 01-06-2022
Publisher: Springer Berlin Heidelberg
Keywords: Vestibular Schwannoma
Subarachnoid Hemorrhage
Aneurysm
Aneurysm
Subarachnoid Hemorrhage
Vestibular Schwannoma
Brain Tumor
Radiotherapy
Epistaxis
Published in: Neurosurgical Review / Issue 5/2022
Print ISSN: 0344-5607
Electronic ISSN: 1437-2320
DOI: https://doi.org/10.1007/s10143-022-01820-5

At a glance: The STEP trials

Springer Medicine

The prognosis and treatment effectiveness of de novo aneurysm formation after radiation therapy for brain tumor

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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