Communicating hydrocephalus after gamma knife radiosurgery for vestibular schwannoma: an MR imaging study

Vestibular schwannomas are common, and gamma knife radiosurgery is a treatment option of symptomatic tumors. Hydrocephalus may be a complication of gamma knife treatment of vestibular schwannoma, though the cause-and-effect relationship can be debated because tumors can cause hydrocephalus without treatment. We present an MR imaging study of an unusual case of communicating hydrocephalus after gamma knife radiosurgery of a vestibular schwannoma in which the timeline of events strongly suggests that gamma knife played a contributory role in the development of hydrocephalus. We discuss risk factors for the development of hydrocephalus after radiation therapy and the role of MR CSF cine-flow study in the evaluation of treatment options for hydrocephalus in this setting.