Cerebral infarction after fractionated stereotactic radiation therapy of benign anterior skull base tumors

Astradsson, Arnar; Rosenschöld, Per Munck af; Poulsgaard, Lars; Ohlhues, Lars; Engelholm, Svend Aage; Feldt‐Rasmussen, Ulla; Marsh, Reginald; Roed, Henrik; Juhler, Marianne

doi:10.1016/j.ctro.2019.02.001

Cited by 3 publications

(3 citation statements)

References 38 publications

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“…Ullrich et al (29) observed that, Moyamoya was diagnosed in 12 of 345 patients (3.5%), at a median follow-up of 54 months after XRT for brain tumors. CI or ischemic stroke after XRT of a skull base tumor, is usually a delayed event (28,(32)(33)(34)(35)(36) and most of the patients in a study of Astradsson et al (37) had a stroke with onset several years after XRT. Tumors of the anterior skull base are located close to anatomical structures such as the Circle of Willis and the cavernous sinus, so that collateral XRT of these structures may occur and lead to vascular sequelae (38,39).…”

Section: Discussionmentioning

confidence: 99%

Cerebral infarction in childhood-onset craniopharyngioma patients results of kraniopharyngeom 2007

Boekhoff¹,

Bison²,

Genzel³

et al. 2021

EJEA

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Background: Cerebral infarction (CI) is a known vascular complication following treatment of suprasellar tumors. Risk factors for CI, incidence rate, and long-term prognosis are unknown for patients with childhood-onset craniopharyngioma (CP).Methods: MRI of 244 CP patients, recruited between 2007 and 2019 in KRANIOPHARYNGEOM 2007, were reviewed for CI. Risk factors for CI and outcome after CI were analyzed.Results: Twenty-eight of 244 patients (11%) presented with CI based on reference assessment of MRI. One CI occurred before initial surgery and one case of CI occurred after release of intracystic pressure by a cyst catheter. 26 of 28 CI were detected after surgical tumor resection at a median postoperative interval of one day (range: 0.5-53 days). Vascular lesions during surgical procedures were documented in 7 cases with CI. No relevant differences with regard to surgical approaches were found. In all 12 irradiated patients, CI occurred before irradiation. Multivariable analyses showed that hydrocephalus and gross-total resection at the time of primary diagnosis/surgery both were risk factors for CI. After CI, quality of life (PEDQOL) and functional capacity (FMH) were impaired.Conclusions: CI occurs in 11% of surgically-treated CP cases. Degree of resection and increased intracranial pressure are risk factors, which should be considered in the planning of surgical procedures for prevention of CI.

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Section: Discussionmentioning

confidence: 99%

Cerebral infarction in childhood-onset craniopharyngioma patients results of kraniopharyngeom 2007

Boekhoff¹,

Bison²,

Genzel³

et al. 2021

EJEA

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show abstract

“…Occlusion of the carotid artery or its branches leading to cerebral infarction or ischemic stroke is a potentially serious and life-threatening complication after stereotactic radiation therapy involving the extra-or intracavernous portion of the carotid artery or the Circle of Willis [67]. Although considered to be relatively rare, radiation-induced cerebral infarction has been reported after single fraction stereotactic radiosurgery or radiation therapy of meningiomas, pituitary adenomas, craniopharyngiomas, and vestibular schwannomas, with an occurrence of 1-7% [24,46,68,69,70]. However, the risk of cerebral infarction may not be increased when compared with the incidence in the general population.…”

Section: Cerebral Infarctionmentioning

confidence: 99%

“…However, the risk of cerebral infarction may not be increased when compared with the incidence in the general population. Predisposing risk factors identified for ischemic events are smoking, hypertension, and hyperlipidemia, as well as increased age [70]. Cerebral infarction is by definition a clinical diagnosis; therefore, subclinical infarctions only detectable by neuroimaging may occur [70].…”

Section: Cerebral Infarctionmentioning

confidence: 99%

Stereotactic Radiotherapy for Benign Skull Base Tumors

Astradsson¹

2022

Skull Base Surgery

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Benign skull base tumors include meningiomas, pituitary adenomas, craniopharyngiomas, and vestibular schwannomas. As an adjuvant therapy to surgery or when surgical treatment carries too high a risk of complications, a highly precise focused radiation, known as stereotactic radiosurgery or fractionated stereotactic radiation therapy, can be delivered to the tumor. The aim of this chapter is to systematically discuss benefits of the therapy, i.e., tumor control as well as complications and risk factors of the therapy relating to vision, hearing, hormone secreting regions, and cerebral vasculature. Meningiomas, pituitary adenomas, craniopharyngiomas, and vestibular schwannomas constitute the majority of primary skull base tumors amenable to stereotactic radiation therapy or radiosurgery and will be described in this chapter.

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Cerebral Infarction in Childhood-Onset Craniopharyngioma Patients: Results of KRANIOPHARYNGEOM 2007

et al. 2021

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BackgroundCerebral infarction (CI) is a known vascular complication following treatment of suprasellar tumors. Risk factors for CI, incidence rate, and long-term prognosis are unknown for patients with childhood-onset craniopharyngioma (CP).MethodsMRI of 244 CP patients, recruited between 2007 and 2019 in KRANIOPHARYNGEOM 2007, were reviewed for CI. Risk factors for CI and outcome after CI were analyzed.ResultsTwenty-eight of 244 patients (11%) presented with CI based on reference assessment of MRI. One CI occurred before initial surgery and one case of CI occurred after release of intracystic pressure by a cyst catheter. 26 of 28 CI were detected after surgical tumor resection at a median postoperative interval of one day (range: 0.5-53 days). Vascular lesions during surgical procedures were documented in 7 cases with CI. No relevant differences with regard to surgical approaches were found. In all 12 irradiated patients, CI occurred before irradiation. Multivariable analyses showed that hydrocephalus and gross-total resection at the time of primary diagnosis/surgery both were risk factors for CI. After CI, quality of life (PEDQOL) and functional capacity (FMH) were impaired.ConclusionsCI occurs in 11% of surgically-treated CP cases. Degree of resection and increased intracranial pressure are risk factors, which should be considered in the planning of surgical procedures for prevention of CI.

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Cerebral infarction after fractionated stereotactic radiation therapy of benign anterior skull base tumors

Abstract: Highlights Cerebral infarction is common after FSRT of benign anterior skull base tumors. Cerebral infarction is not more common after FSRT than in the general population. Special attention should be paid to cerebral vasculature, during dose planning.

Cited by 3 publications

References 38 publications

Cerebral infarction in childhood-onset craniopharyngioma patients results of kraniopharyngeom 2007

Cerebral infarction in childhood-onset craniopharyngioma patients results of kraniopharyngeom 2007

Stereotactic Radiotherapy for Benign Skull Base Tumors

Cerebral Infarction in Childhood-Onset Craniopharyngioma Patients: Results of KRANIOPHARYNGEOM 2007

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Cerebral infarction after fractionated stereotactic radiation therapy of benign anterior skull base tumors

Abstract: Highlights Cerebral infarction is common after FSRT of benign anterior skull base tumors. Cerebral infarction is not more common after FSRT than in the general population. Special attention should be paid to cerebral vasculature, during dose planning.

Cited by 3 publications

References 38 publications

Cerebral infarction in childhood-onset craniopharyngioma patients  results of kraniopharyngeom 2007

Cerebral infarction in childhood-onset craniopharyngioma patients  results of kraniopharyngeom 2007

Stereotactic Radiotherapy for Benign Skull Base Tumors

Cerebral Infarction in Childhood-Onset Craniopharyngioma Patients: Results of KRANIOPHARYNGEOM 2007

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Cerebral infarction in childhood-onset craniopharyngioma patients results of kraniopharyngeom 2007

Cerebral infarction in childhood-onset craniopharyngioma patients results of kraniopharyngeom 2007