Hydrocephalus After Gamma Knife Radiosurgery for Vestibular Schwannoma: Favorable Outcomes After Shunt Placement

Recent literature has described the development of a normal pressure hydrocephalus after Gamma Knife radiosurgery in patients with vestibular schwannoma. However, there is minimal detail regarding the clinical course and extent of recovery in these patients following shunt placement. This information would help clinicians weigh the risks and benefits of shunt surgery. We describe the clinical course of two such patients who received shunt placement and made a significant recovery not only in gait but also in their cognitive function. Unlike idiopathic normal pressure hydrocephalus, where patients can have a limited recovery after shunt placement, patients with this form of secondary hydrocephalus appear to make a significant recovery following shunting. Due to the complexity of these patients, it is possible for clinicians to attribute normal pressure hydrocephalus symptoms to neurodegenerative disease or vestibular dysfunction. Thus, it is vital that clinicians have a high index of suspicion for hydrocephalus in vestibular schwannoma patients receiving Gamma Knife radiosurgery so that these patients can be treated early with shunt placement.