Although craniopharyngiomas comprise only 3 per cent of all intracranial tumours (Walsh and Hoyt, I969), they represent x3 per cent of intracranial neoplasms in childhood (Frazier, 1936; Ingraham and Scott, 1946) and 30 per cent of all new growths in the hypophyseal area (Love and Marshall, 1950). Since ocular signs are frequently the presenting feature of these tumours, many of the patients being first seen at an eye clinic, their recognition by the ophthalmologist is clearly of great importance. Certainly early diagnosis is desirable, since modem advances in treatment have resulted in better prospects for successful eradication of the growth, if its detection is timely and its location favourable.At the Institute of Neurological Sciences (INS), Glasgow, approximately three new cases are discovered each year, and in this communication we report the results of a 20-year study.
Material and methodsAltogether 45 patients, 22 men and 23 women (mean age 25 years), suffering from craniopharyngioma and treated at the INS during the past 20 years, were the subjects of this retrospective study. One of us (RJSS) had examined most of the patients throughout the 20 years and was responsible for the ophthalmological examinations, compnsing visual acuity, ocular movements, pupil reactions, ophthalmoscopy, and visual field testing using the Bjerrum screen.Results Fig. i shows that the patients were divided equally into male and female categories ranging from 2 to 6i years. They can be placed in three groups of approximately the same numbers, children of 13 years and under, young adults of 14 to 29 years, and older adults of 30 years and over. While more than half presented in the first two decades of life, and more than two-thirds before the age of 30, many were above that age before symptoms were manifest.