Document Detail


Neuropsychological results of craniopharyngioma surgery in adults: a prospective study.
MedLine Citation:
PMID:  9657489     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The optimal management of craniopharyngiomas is a topic of ongoing debate. Supporters of limited surgery for craniopharyngiomas claim that more radical approaches are afflicted with adverse neuropsychological sequelae. Since prospective studies on this issue have not yet been performed, we assessed neuropsychological functioning in adults before and after craniopharyngioma surgery. METHODS: Thirteen adults with an age range of 17-76 years (mean, 45 years) were included in the study. Surgery included a transcranial procedure in 10 patients. The bifrontal interhemispheric approach predominated (n = 7). Neuropsychological evaluation was performed before and 3 months after surgery. The test battery was adjusted to evaluate function related to structures in the operative trajectory and at the tumor site. RESULTS: A complete tumor removal was accomplished in eight patients and subtotal removal in three patients. IQ scores for verbal intelligence were in the normal range and not affected by surgery (mean IQ score preoperative: 106.8; postoperative 107.4). In 12 of 13 patients, immediate recall, delayed recall and recognition memory were not impaired after surgery. Postoperative results for abstract thinking were in the normal or above-normal range. Cognitive speed was impaired in three patients preoperatively and in two patients postoperatively. Overall results were significantly better after surgery. Word fluency was not affected by surgery. Quality of life for the category "sleep" was impaired preoperatively, and this improved after surgery. Otherwise, quality of life was normal both before and after surgery. CONCLUSIONS: Neuropsychological performance and quality of life are generally not impaired after surgical removal of craniopharyngiomas. The findings support the attitude that the initial therapy of craniopharyngiomas should be an attempt at total removal.
Authors:
J Honegger; A Barocka; B Sadri; R Fahlbusch
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Surgical neurology     Volume:  50     ISSN:  0090-3019     ISO Abbreviation:  Surg Neurol     Publication Date:  1998 Jul 
Date Detail:
Created Date:  1998-07-16     Completed Date:  1998-07-16     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0367070     Medline TA:  Surg Neurol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  19-28; discussion 28-9     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, University of Erlangen-Nürnberg, Erlangen, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Cognition
Craniopharyngioma / physiopathology*,  psychology*,  surgery
Female
Humans
Male
Middle Aged
Neuropsychological Tests
Occupations
Pituitary Neoplasms / physiopathology*,  psychology*,  surgery
Prospective Studies
Quality of Life
Treatment Outcome

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