Cerebellar encephalomalacia on magnetic resonance imaging after removal of acoustic tumor

Abstract

MRI is widely used for postoperative surveillance of patients undergoing surgery for removal of acoustic neuroma. The purpose of this study was to investigate the frequency and pattern of postoperative changes in the cerebellum and brain stem on MRI after removal of acoustic neuroma. A retrospective study was conducted in 30 consecutive patients who underwent postoperative MRI between 1994 and 1995. The timing of the scans after surgery ranged from 12 months to 10 years. T₂-weighted turbo spin-echo images revealed cerebellar encephalomalacia in 17 of 30 cases. Cerebellar encephalomalacia was found more consistently in patients who had large tumors and was more frequent after the suboccipital approach. Encephalomalacia is largely caused by gliotic changes in the adjacent cerebellar tissues after tumor removal.

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References

1. Jackler

Shapiro

Dillon

Gadolinium-DTPA enhanced magnetic resonance imaging in acoustic neuroma diagnosis and management. Otolaryngol Head Neck Surg 1990; 102:670–7.

2. Lhuillier

Doyon

Halimi

Magnetic resonance imaging of acoustic neuromas: pitfalls and differential diagnosis. Neuroradiology 1992; 34:144–9.

3. Shelton

Unilateral acoustic tumor: How often do they recur after translabyrinthine removal? Laryngoscope 1995; 105:958–66.

4. Thedinger

Glasscock

Cueva

Postoperative radiographic evaluation after acoustic neuroma and glomus jugulare tumor removal. Laryngoscope 1992; 102:261–6.

5. Smith

Castillo

Campbell

Baseline and follow-up MRI of the internal auditory canal after suboccipital resection of an acoustic schwannoma. Neuroradiology 1996; 37:317–20.

6. Cass

Kartush

Wilner

Comparison of computerized tomography and resonance imaging for the postoperative assessment of residual acoustic tumor. Otolaryngol Head Neck Surg 1991; 104:182–90.

7. Bradley

WG.

Pathophysiologic correlates of signal alterations. In: Brandt-Zawadzki

Norman

, editors. Magnetic resonance imaging of the central nervous system. New York: Raven; 1987. p. 23–42.

8. Brant-Zawadzki

Ischemia. In: Stark

Bradley

, editors. Magnetic resonance imaging. Mosby; 1988.

9. Carrau

MRL

Weissman

Janecka

Computerized tomography and magnetic resonance imaging following cranial base surgery. Laryngoscope 1991; 101:951–9.

10.

10. Kahn

Heiserman

Hodak

Prefrontal sonic treatment: MR findings. AJNR Am J Neuroradiol 1992; 13:1493–4.

11.

11. Reider-Groswasser

Cohen

Costeff

Late CT findings in brain trauma: relationship to cognitive and behavioral sequelae and to vocational outcome. AJR Am J Roentgenol 1993; 160:147–52.

12.

12. Marshall

Bradley

Marshall

Deep white matter infarction: correlation of MR imaging and histopathologic findings. Radiology 1988; 167:517–22.

13.

13. Keeney

Adcock

McArdle

CB.

Prospective observations of 100 high-risk neonates by high-field (1.5 Tesla) magnetic resonance imaging of the central nervous system. II. Lesions associated with hypoxic-ischemic encephalopathy. Pediatrics 1991; 87: 431–8.

14.

14. Gray

Tudehope

Masel

Cystic encephalomalacia and intrauterine herpes simplex virus infection. Pediatr Radiol 1992; 22:529–32.

15.

15. Millen

Daniels

DL.

The effect of intracranial surgical trauma on gadolinium-enhanced magnetic resonance imaging. Laryngoscope 1994; 104:804–13.

16.

16. Wiet

Teixido

Liang

Complications in acoustic neuroma surgery. In: Jackler

, editor. Acoustic neuroma. I: surgical management. Otolaryngologic clinics of North America; Philadelphia: WB Saunders; 1992. p. 389–412.