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Social and psycho-intellectual outcome
following radical removal of craniopharyngiomas in childhood. A
prospective series
Pierre-Kahn A, Recassens C, Pinto G, Thalassinos
C, Chokron S, Soubervielle JC, Brauner R, Zerah
M, Sainte Rose C
Department of Pediatric Neurosurgery, Groupe hospitalier Necker
Enfants Malades Paris, 149 rue de Sevres, 75743, Paris, Cedex 15,
France, alain.kahn@nck.ap-hop-paris.fr.
Background. A prospective study on childhood
craniopharyngiomas (CPs) was conducted from 1994 to 1998 to appreciate
the pre- and postoperative clinical, endocrine, mental, and
intellectual status of the patients and to determine the incidence and
severity of the postoperative hypothalamic syndrome.
Methods.
The series included 14 consecutive CPs.
Twelve were retrochiasmatic and
intraventricular, and two were partly prechiasmatic and
extraventricular.
All were treated with the aim of
"total" removal.
The removal was "total" in nine
cases but incomplete in the other five.
Immediate postoperative follow-up was
uncomplicated in all cases.
Conclusion. At 2-year
follow-up, the two children with an extraventricular CP and a
"total" tumor removal were intellectually normal, had no
hypothalamic syndrome, and attended normal school with good
results.
The 12 others, although still
intellectually normal, were more or less severely affected by a
hypothalamic syndrome which altered their social insertion and caused
academic failure.
The authors conclude from this study that
radical surgery should be reserved to extraventricular CPs only.
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