Postsurgical IQ and behavioral data on twenty patients with a history of childhood craniopharyngioma

Clopper, Richard R.; Meyer, Walter J.; Udvarhelyi, George B.; Money, John; Aarabi, Bizhan; Mulvihill, John J.; Piasio, Mark

doi:10.1016/0306-4530(77)90006-3

Cited by 37 publications

(12 citation statements)

References 7 publications

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“…Sig nificant disturbances of behavior, comportment, and per sonality can often be present with a normal, or near nor mal, neuropsychological test profile [36]. The frequency of behavioral disturbances in our patients is consistent with results of previous studies [21,22], and these obser vations strongly suggest that assessments of behavioral changes be included in outcome studies. Qualitative de scriptions of behavior from parents and teachers are extremely valuable, and were critical in the conduct of our study.…”

Section: Discussionsupporting

confidence: 80%

Neurobehavioral Outcome in Pediatric Craniopharyngioma

et al. 1997

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Neurobehavioral dysfunction occurs in children with craniopharyngioma, both before and after treatment, and its impact on outcome may not be fully appreciated. Also unclear is whether neurobehavioral outcome relates more to tumor location or surgical factors. We reviewed the records of 20 children with craniopharyngioma who were seen between 1983 and 1995. All children had subfrontal craniotomy and either partial (14 children) or gross total (6 children) resection of their tumors. In addition to traditional neuropsychological testing, we assessed social behavior and school performance using standardized ratings based on family interviews and school records. Over a mean follow-up period of 38 months, only 3 of 20 children had a good outcome in all three categories, and 12 of 20 had moderate or severe impairment in at least one category. Outcome did not differ between those who had partial and those with gross total resection. We conclude that neurobehavioral disorders are common and cause important morbidity in children after treatment for craniopharyngioma. To evaluate these impairments in future outcome studies, standard neuropsychological testing should be supplemented by specific behavioral assessments to capture the full range of neurobehavioral disability. In this series, partial versus gross total resection did not influence outcome, implying that tumor location in diencephalic and limbic regions is a more important factor.

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Section: Discussionsupporting

confidence: 80%

Neurobehavioral Outcome in Pediatric Craniopharyngioma

et al. 1997

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“…Importantly, many cases appear to be more severely affected in the realms of social, behavioral, and emotional function than they are by neuro-cognitive or physical impairments[11,14,16–18,24]. For instance, some studies focusing primarily on neurocognitive performance in survivors of treated childhood CP have reported normal IQ scores in addition to normal achievement, attention, and verbal memory[14,19,25,26]. Rather, neurocognitive impairments were associated with depression, somatic concerns, and deficits in executive function and spatial working memory[18,19].…”

Section: Discussionmentioning

confidence: 99%

“…Social and emotional dysfunction in pediatric patients with CP may have a severe impact on mood, attention, familial and other interpersonal dynamics, and school function. Common social manifestations arising in patients with childhood CP include internalizing behavior, withdrawal, and social isolation[8,25,27]. Additional behaviors including emotional outbursts, impulsivity, and aggressiveness have also been frequently described in this population[11,14,18,28].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Neurobehavioral, Social, and Emotional Dysfunction in Patients Treated for Childhood Craniopharyngioma: A Systematic Literature Review

et al. 2013

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BackgroundCraniopharyngiomas (CP) are locally invasive and frequently recurring neoplasms often resulting in neurological and endocrinological dysfunction in children. In addition, social-behavioral impairment is commonly reported following treatment for childhood CP, yet remains to be fully understood. The authors aimed to further characterize the prevalence of neurobehavioral, social, and emotional dysfunction in survivors of childhood craniopharyngiomas.Materials and MethodsA systematic literature review was conducted in PubMed to identify studies formally assessing neurobehavioral, social, and emotional outcomes in patients treated for CP prior to 18 years of age. Studies published between the years 1990-2012 that reported the primary outcome (prevalence of neurobehavioral, social, emotional/affective dysfunction, and/or impaired quality of life (QoL)) in ≥10 patients were included.ResultsOf the 471 studies screened, 11 met inclusion criteria. Overall neurobehavioral dysfunction was reported in 51 of 90 patients (57%) with available data. Social impairment (i.e. withdrawal, internalizing behavior) was reported in 91 of 222 cases (41%). School dysfunction was reported in 48 of 136 patients (35%). Emotional/affective dysfunction was reported in 58 of 146 patients (40%), primarily consisting of depressive symptoms. Health related quality of life was affected in 49 of 95 patients (52%). Common descriptors of behavior in affected children included irritability, impulsivity, aggressiveness, and emotional outbursts.ConclusionsNeurobehavioral, social, and emotional impairment is highly prevalent in survivors of childhood craniopharyngioma, and often affects quality of life. Thorough neurobehavioral/emotional screening and appropriate counseling is recommended in this population. Additional research is warranted to identify risk factors and treatment strategies for these disorders.

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“…Post-operative performance scores of 1 (excellent) and 2 (good) were reported in 53–73 and 66–92% respectively, after gross total resection and partial resection with radiotherapy. These complications, associated with aggressive surgical removal and the degree of hypothalamic dysfunction, had an impact on quality of life (Clopper et al, 1977; Hoffman et al, 1977; Cavazzuti et al, 1983; De Vile et al, 1996a; Anderson et al, 1997; Villani et al, 1997; Donnet et al, 1999; Habrand et al, 1999; Carpentieri et al, 2001; Merchant et al, 2002; Poretti et al, 2004; Pierre-Kahn et al, 2005; Sands et al, 2005; Dekkers et al, 2006; Karavitaki et al, 2006; Puget et al, 2007; Muller, 2011). …”

Section: Criticism Of the Traditional Surgical Approachmentioning

confidence: 99%

Treatment Strategies in Childhood Craniopharyngioma

Puget¹

2012

Front. Endocrin.

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The surgical management of craniopharyngiomas in children remains one of the more controversial topics in pediatric neurosurgery. Theoretically, the benign histology implies that total surgical excision would be sufficient to provide a cure. It has been widely established however, that in certain cases total excision may lead to unacceptable hypothalamic injury. The therapeutic goals for pediatric craniopharyngiomas therefore, require not just cure of the disease but also preservation of function. Over the last 15 years, there has been a growing worldwide advocacy for less extensive resection and for the utilization of multimodality therapy to limit morbidity. With this in mind, risk-adapted strategies designed to preserve hypothalamic structures have been developed. The preliminary results of these strategies appear to be encouraging. However, the long-term clinical outcome in terms of post irradiation complications and management of relapses is currently unknown.

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Postsurgical IQ and behavioral data on twenty patients with a history of childhood craniopharyngioma

Cited by 37 publications

References 7 publications

Neurobehavioral Outcome in Pediatric Craniopharyngioma

Neurobehavioral Outcome in Pediatric Craniopharyngioma

Prevalence of Neurobehavioral, Social, and Emotional Dysfunction in Patients Treated for Childhood Craniopharyngioma: A Systematic Literature Review

Treatment Strategies in Childhood Craniopharyngioma

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