RADT-33. INTRATUMORAL HEMORRHAGE IN VESTIBULAR SCHWANNOMAS FOLLOWING GAMMA KNIFE STEREOTACTIC RADIOSURGERY

Abstract INTRODUCTION Intratumoral hemorrhage (ITH) is a rare occurrence in vestibular schwannomas (VS) resulting worsening and cranial nerve deficits. Scarce data described the occurrence, management, outcomes of ITH after stereotactic radiosurgery (SRS). OBJECTIVE The aim this study to delineate incidence, presentation, VS patients following SRS. METHODS A total 2058 with underwent Gamma Knife (GKRS) at University Pittsburgh Medical Center between 1987 2022. authors identified ITH. Their clinical, imaging are reported analyzed. RESULTS 1902 had sufficient clinical follow-up data. Five Koos III (n = 1) IV 4) developed GKRS, cumulative incidence rate 0.26%. age presentation ranged from 62 79 years, 3 were males. time diagnosis GKRS 1-13 months, 2-130 months. Three bleeding risk factors. One patient required urgent surgical intervention due volume, while other four initially observed. remained stable no delayed intervention. Histopathological analysis revealed multiple fragments S-100–positive cells, hemorrhage, hemosiderin-laden macrophages. At last follow-up, 4 clinically improved, one stable.ConclusionVS SRS complication Patient-tailored management vital based on acuity, size characteristics.