Abstract
PurposeCraniopharyngiomas remain a challenging entity for neurosurgeons because of their deep-seated, midline location, and intimate relationship with critical neurovascular structures. With high long-term survival rates, patients with craniopharyngioma are likely to experience significant late morbidity related to both disease and therapy.Method and resultsIn this paper, we present two cases of late vascular complications after multi-modal treatment of craniopharyngioma.ConclusionAvailable data suggests that pediatric patients with craniopharyngioma represent a particularly vulnerable group.
Highlights
Historical backgroundCraniopharyngiomas account for 5–10% of childhood brain tumors
Craniopharyngiomas remain a challenging entity for neurosurgeons because of their deep-seated, midline location and intimate relationship with critical neurovascular structures
A few case reports have been released but the subject of vascular complications after surgical treatment of craniopharyngioma has not received a lot of attention
Summary
Craniopharyngiomas account for 5–10% of childhood brain tumors. They are histologically mostly benign, malignant transformation exists, tumors that arise in the suprasellar region and often affect young patients [1]. One paper describes the fusiform dilatation in as many as 29% of patients younger than 18 years who have undergone surgery for craniopharyngioma [2] This has later been contradicted by a large multicenter material that states that fusiform dilatations of the carotid occur in 2.4% of surgically treated childhood-onset adamantinomatous craniopharyngioma [14]. Our patient is a young girl born in 1998, who at the age of 5 was diagnosed with a cystic craniopharyngioma causing secondary obstructive hydrocephalus (Fig. 1a) She underwent a transnasal endoscopic fenestration of the cyst and the residual solid component was treated with a single fraction Gamma Knife lesion in 2004. MRI including MRA and MR perfusion revealed a right-sided carotid stenosis and a vascular pattern resembling moyamoya syndrome (Fig. 2c). 18 months after the surgery, she has recovered from her hemidystonia but still suffers impaired sensibility in her left side
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